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As hydrogen is touted as a key player in the decarbonization of modern society, it is critical to enable quantitative hydrogen (H) analysis at high spatial resolution and, if possible, at the atomic scale. H has a known deleterious impact on the mechanical properties (strength, ductility, toughness) of most materials that can hinder their use as part of the infrastructure of a hydrogen-based economy. Enabling H mapping including local hydrogen concentration analyses at specific microstructural features is essential for understanding the multiple ways that H affect the properties of materials including embrittlement mechanisms and their synergies. In addition, spatial mapping and quantification of hydrogen isotopes is essential to accurately predict tritium inventory of future fusion power plants thus ensuring their safe and efficient operation. Atom probe tomography (APT) has the intrinsic capability to detect H and deuterium (D), and in principle the capacity for performing quantitative mapping of H within a material's microstructure. Yet, the accuracy and precision of H analysis by APT remain affected by complex field evaporation behavior and the influence of residual hydrogen from the ultrahigh vacuum chamber that can obscure the signal of H from within the material. The present article reports a summary of discussions at a focused workshop held at the Max-Planck Institute for Sustainable Materials in April 2024. The workshop was organized to pave the way to establishing best practices in reporting APT data for the analysis of H. We first summarize the key aspects of the intricacies of H analysis by APT and then propose a path for better reporting of the relevant data to support interpretation of APT-based H analysis in materials., Competing Interests: Conflict of Interest The authors declare that they have no competing interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Microscopy Society of America.)

To further understand the impact of deficiency of the autoimmune regulator ( Aire ) gene during the adhesion of medullary thymic epithelial cells (mTECs) to thymocytes, we sequenced single-cell libraries (scRNA-seq) obtained from Aire wild-type (WT) ( Aire wt/wt ) or Aire -deficient ( Aire wt/mut ) mTECs cocultured with WT single-positive (SP) CD4 + thymocytes. Although the libraries differed in their mRNA and long noncoding RNA (lncRNA) profiles, indicating that mTECs were heterogeneous in terms of their transcriptome, UMAP clustering revealed that both mTEC lines expressed their specific markers, i.e., Epcam, Itgb4 , Itga6 , and Casp3 in resting mTECs and Ccna2, Pbk , and Birc5 in proliferative mTECs. Both cocultured SP CD4 + thymocytes remained in a homogeneous cluster expressing the Il7r and Ccr7 markers. Comparisons of the two types of cocultures revealed the differential expression of mRNAs that encode transcription factors ( Zfpm2, Satb1 , and Lef1 ), cell adhesion genes ( Itgb1 ) in mTECs, and Themis in thymocytes, which is associated with the regulation of positive and negative selection. At the single-cell sequencing resolution, we observed that Aire acts on both Aire WT and Aire -deficient mTECs as an upstream controller of mRNAs, which encode transcription factors or adhesion proteins that, in turn, are posttranscriptionally controlled by lncRNAs, for example, Neat1, Malat1, Pvt1, and Dancr among others. Under Aire deficiency, mTECs dysregulate the expression of MHC-II, CD80, and CD326 (EPCAM) protein markers as well as metabolism and cell cycle-related mRNAs, which delay the cell cycle progression. Moreover, when adhered to mTECs, WT SP CD4 + or CD8 + thymocytes modulate the expression of cell activation proteins, including CD28 and CD152/CTLA4, and the expression of cellular metabolism mRNAs. These findings indicate a complex mechanism through which an imbalance in Aire expression can affect mTECs and thymocytes during adhesion., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Monteiro, Duarte, Machado, Mascarenhas, Palma, García, Nakaya, Cunha, Donadi and Passos.)

Background/Objectives : Crohn's disease is a chronic and debilitating intestinal disorder that alternates between remission and active flare-ups, often leading to hospitalization. Social support is known to enhance adaptation to the disease and modulate stress perception in patients, while stress may exacerbate symptoms. The aim of this study was to examine the roles of perceived stress and social support in Crohn's disease and their impact on the frequency of flare-ups. Methods : A cross-sectional observational study was conducted, assessing stress and social support in a cohort of 91 patients with Crohn's disease during flare-up and remission phases. The Perceived Stress Scale (PSS-14) and a Social Support Questionnaire were utilized for evaluation. We examined the relationship between stress and social support in Crohn's disease. The interaction between the variables studied was also observed, considering the stage of the disease. Finally, we carried out an analysis of the influence of these two variables on the development of flare-ups in Crohn's disease. Results : The study revealed that patients experience higher stress levels during flare-ups and that these levels are amplified by a lack of social support. A significant relationship was identified between the levels of social support and the occurrence of flare-ups, indicating that better social support is associated with fewer flare-ups. Conclusions : Patients with Crohn's disease in the flare-up phase are subject to considerable stress. A deficit in social support is linked to an increase in stress levels. The interaction between social support and stress plays a critical role in the development of flare-ups.

We present a case report of a patient with infective endocarditis. He came to the emergency room with respiratory failure due to severe pneumonia and pulmonary edema. On 2D transesophageal echocardiography, vegetations were seen in both mitral and aortic valves, with mitral valve perforation and severe regurgitation. His clinical presentation and severity of the disease made him suitable for urgent valve repair. He was submitted to mitral valvuloplasty with closure of the valve perforation and insertion of a bioprosthetic aortic valve. Despite significant clinical improvement, a post-surgical complication was noted with new-onset lung injury after cardiopulmonary bypass. This is an interesting case of a patient with suspected retrograde valve involvement, affecting the aortic valve, the mitral-aortic intervalvular fibrosa, and the mitral valve, ending with mitral valve abscess with leaflet perforation and valvular regurgitation., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Paula et al.)

Background: Steatohepatitis is common in persons living with HIV and may be associated with gut microbial translocation (MT). However, few studies have evaluated the gut-liver axis in persons living with HIV. In the Women's Interagency HIV Study, we examined the associations of HIV and circulating biomarkers linked to MT and gut damage using the FibroScan-aspartate aminotransferase (FAST) score, a noninvasive surrogate for steatohepatitis with advanced fibrosis., Methods: Among 883 women with HIV and 354 without HIV, we used multivariable regression to examine the associations of HIV and serum biomarkers linked to MT and gut damage (kynurenine and tryptophan ratio, intestinal fatty acid-binding protein, soluble CD14, and soluble CD163) with a log-transformed FAST score after adjusting for key covariates. We used a path analysis and mediation models to determine the mediating effect of each biomarker on the association of HIV with FAST., Results: HIV infection was associated with a 49% higher FAST score. MT biomarker levels were higher in women with HIV than women without HIV ( P < .001 for each). MT biomarkers mediated 13% to 32% of the association of HIV and FAST score., Conclusions: Biomarkers linked to MT and gut damage are associated with a higher FAST score and mediate the association of HIV with a higher FAST score. Our findings suggest that MT may be an important mechanism by which HIV increases the risk of steatohepatitis with advanced fibrosis., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Introduction: Men who assault their partners present deficits in the social skills necessary for adequate interpersonal interaction. Not all of them have the same difficulties, thus they do not constitute a homogeneous group. Various studies have proposed different typologies of abusers based on their sociodemographic characteristics, criminal history, intensity and extent of violent or psychopathological traits. The majority of these investigations have been conducted in community samples, prompting the question of their validity in samples of men convicted of gender violence. The aim of this study was to establish a typology of men convicted in Spain for a gender violences crimes., Methodology: A total of 365 men participated and were subdivided into three classes of abusers based on their childhood, family experiences with violence, criminal history, sexist attitudes and attitudes toward violence, intensity and type of violence, psychopathological state and attachment style., Results: Coinciding with the results found in other research, 30% of the participants were classified as generally violent. They engaged in severe forms of physical, psychological and sexual violence and were more likely to do so than the rest. Additionally, they are more likely to present psychopathological problems and an antisocial character. Twenty-one percent were classified as dysphoric/borderline. They are characterized by minor forms of psychological violence, borderline or depressive symptomatology and an anxious attachment style. The remaining 49% were classified as familial or normalized abusers. This group exhibits moderate attitudes toward violence and sexism, resulting in less psychological and physical aggression. They do not present psychopathological problems and are likely to present a secure attachment style., Discussion: It is argued that determining the psychological characteristics of each type of abuser would contribute to improving and adapting intervention protocols in Spain, leading to a significant improvement in the current issue of abuse., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Osa-Subtil, Arias Astray, Mateo Fernandez and de Dios-Duarte.)

Introduction: Adult attachment can be understood as a cognitive and emotional system concerning oneself and others, based on previous attachment experiences throughout life. This system automatically affects relationships with others. Because of its importance in the interpersonal domain, it has been studied on numerous occasions in research on intimate partner violence. The aim of this study was to obtain evidence of validity of the Adult Attachment Questionnaire (AAQ) in a sample of 331 men convicted of intimate partner violence against women (IPVAW)., Methods: The AAQ assesses adult attachment style in four dimensions that, together, yield four attachment categories. A psychometric analysis was performed, including reliability analysis and confirmatory factor analysis of the items, which ratified the factorial structure of the questionnaire. For a correct fit of the model, it was necessary to eliminate 4 of the items from the original scale., Results: A latent profile analysis was also carried out, which identified four attachment styles: secure, preoccupied/anxious, avoidant/dismissing and fearful. Reliability indices were adequate. In general, the attachment profiles obtained ranges and means similar to those found in the general population study. The distribution of attachment styles was not equal: 50.57% of the participants presented secure attachment, 4.57% avoidant/dismissing attachment, 36.9% preoccupied/anxious, and 8.57% fearful., Discussion: In conclusion, a valid and reliable instrument was determined based on the original AAQ scale to measure attachment in men convicted of IPVAW., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Osa-Subtil, Arias Astray, Mateo Fernandez and de Dios-Duarte.)

(1) Background: In the treatment of colorectal cancer, it is important to consider different psychosocial factors. Our first objective was to measure the levels of perceived stress in subjects diagnosed with colorectal cancer awaiting potentially curative surgery. Also, we aimed to analyse what coping styles these patients used, how they perceived their illness, and the subsequent influence of these factors on their levels of stress. (2) Methods: Stress, coping styles and illness perception were assessed in a sample of 107 patients. The instruments used were the Perceived Stress Scale (PSS-14), the Stress Coping Questionnaire (SCQ) and the Brief Illness Perception Questionnaire (BIPQ-R). (3) Results: Patients using active coping styles have lower levels of perceived stress ( p = 0.000; p = 0.002) than patients making use of passive coping styles ( p = 0.000; p = 0.032; p = 0.001). A multi-linear regression model found that the perception of illness and the use of the negative approach coping style ( p = 0.000; p = 0.001) influence an increase in perceived stress, and that a decrease in stress levels was influenced by the problem solving coping style ( p = 0.001). (4) Conclusions: Based on our results, we recommend preventive interventions in care patients undergoing colorectal cancer surgery.

The appearance of water stress episodes triggers leaf abscission and decreases Ilex paraguariensis yield. To explore the mechanisms that allow it to overcome dehydration, we investigated how the root gene expression varied between water-stressed and non-stressed plants and how the modulation of gene expression was linked to metabolite composition and physiological status. After water deprivation, 5160 differentially expressed transcripts were obtained through RNA-seq. The functional enrichment of induced transcripts revealed significant transcriptional remodelling of stress-related perception, signalling, transcription, and metabolism. Simultaneously, the induction of the enzyme 9-cis-expoxycarotenoid dioxygenase (NCED) transcripts reflected the central role of the hormone abscisic acid in this response. Consequently, the total content of amino acids and soluble sugars increased, and that of starch decreased. Likewise, osmotic adjustment and radical growth were significantly promoted to preserve cell membranes and water uptake. This study provides a valuable resource for future research to understand the molecular adaptation of I. paraguariensis plants under drought conditions and facilitates the exploration of drought-tolerant candidate genes.

Purpose of Review: Chronic liver disease is a major cause of morbidity and mortality amongst people living with HIV (PLWH). Emerging data suggests that gut microbial translocation may play a role in driving and modulating liver disease, a bi-directional relationship termed the gut-liver axis. While it is recognized that PLWH have a high degree of dysbiosis and gut microbial translocation, little is known about the gut-liver axis in PLWH., Recent Findings: Recent studies have shown that microbial translocation can directly lead to hepatic inflammation, and have linked gut microbial signatures, dysbiosis, and translocation to liver disease in PLWH. Additionally, multiple trials have explored interventions targeting the microbiome in PLWH. Emerging research supports the interaction between the gut microbiome and liver disease in PLWH. This offers new opportunities to expand our understanding of the pathophysiology of liver disease in this population, as well as to explore possible clinical interventions., (© 2023. The Author(s).)

(1) Background: Coping includes the specific cognitive processes and behaviours that the patient uses when faced with the stress of living with a chronic disease. Self-efficacy is the knowledge that individuals have about their abilities and their confidence to face a problem or cope with a situation (disease). The aim of this study was to explore the role of coping and self-efficacy in inflammatory bowel disease. (2) Materials and Methods: A total of 92 participants were included (33 had been diagnosed with Crohn's disease, 23 with ulcerative colitis and 36 were healthy participants). The Coping Strategies Inventory was used to measure which coping strategies were employed, differentiating them as active or passive. The General Self-Efficacy Scale was used to measure self-efficacy. (3) Results: The results indicate that people with inflammatory bowel disease used strategies related to passive coping more than healthy people (mean of 36.39 ± 13.92 vs. 29.77 ± 10.70, p = 0.017). Additionally, people with inflammatory bowel disease used social withdrawal more than healthy participants (mean of 8.30 ± 5.07 vs. 4.47 ± 4.17, p < 0.001). In addition, there are significant differences in emotion-focused engagement coping strategies. People with inflammatory bowel disease used this strategy less than healthy people (mean of 21.77 ± 7.75 vs. 25.03 ± 7.00, p = 0.044). Finally, healthy participants used the emotion-focused disengagement strategy less than those diagnosed with inflammatory bowel disease (mean of 9.81 ± 7.74 vs. 15.61 ± 10.14, p = 0.004). (4) Conclusions: Actions aimed at the development of active coping strategies and patient socialisation must be included in the treatment of inflammatory bowel disease.

Based on the incorporation of pre-exposure prophylaxis (PrEP) as an HIV prevention strategy and considering the need to comprehend the use of medication among young people, this article analyzes narratives of gay men and transgender women from Belo Horizonte, Minas Gerais State, Brazil, participating in the PrEP1519 study. This is a qualitative research, based on the interpretative anthropology, developed by 10 in-depth interviews with PrEP users followed-up for at least three months between October and November 2019. The results showed that the drug was seen as the main motivation for participating in the study and as a strategy combined with the use of condoms, whether as additional prevention, or assuming the leading role. The medication revealed signs built by the gender performances and their relation to other medications, especially the experience of trans girls in hormonal therapy. Regarding the socialization of the use of PrEP, the narratives showed that there was no secret between the couples, which did not meant that stigmas on the association with HIV did not exist, mainly in the virtual context. In the family environment, they reported questions about the preventive function of the medication and the voluntary nature of the participation in the study. The youth's narratives revealed plural meanings of the medication and its social use, composing both the boys' and girls' performances. The signs attributed to the medication indicated that in addition to maintenance of health, the medication improves life and sexual freedom.

(1) Background: The aim of this study was to explore the role of perceived stress and the health locus of control in Crohn's disease and their influence upon the development of flare-ups of this disease. (2) Methods: Stress and the external locus of control were evaluated in a sample of 64 Crohn's patients (flare-up phase versus latency phase). The perceived stress scale (PSS-14) and the multidimensional health locus of control scale were the measurement instruments used. (3) Results: The results indicate that the patients have high stress levels during a flare-up (26.13; 27.44; 28.79; 29.67); high stress levels (28.07; 29.67; 27.44; 28.07) if they have a high external locus of control; and that the external locus of control and stress levels have a significant influence upon the existence of flare-ups in those patients with low external locus of control levels (χ2 = 11.127; df = 1: p < 0.001). (4) Conclusions: Actions aimed at reducing stress and external locus of control levels are necessary in Crohn's disease.

Background: The autoimmune regulator (Aire) gene is critical for the appropriate establishment of central immune tolerance. As one of the main controllers of promiscuous gene expression in the thymus, Aire promotes the expression of thousands of downstream tissue-restricted antigen (TRA) genes, cell adhesion genes and transcription factor genes in medullary thymic epithelial cells (mTECs). Despite the increasing knowledge about the role of Aire as an upstream transcriptional controller, little is known about the mechanisms by which this gene could be regulated., Results: Here, we assessed the posttranscriptional control of Aire by miRNAs. The in silico miRNA-mRNA interaction analysis predicted thermodynamically stable hybridization between the 3'UTR of Aire mRNA and miR-155, which was confirmed to occur within the cellular milieu through a luciferase reporter assay. This finding enabled us to hypothesize that miR-155 might play a role as an intracellular posttranscriptional regulator of Aire mRNA. To test this hypothesis, we transfected a murine mTEC cell line with a miR-155 mimic in vitro, which reduced the mRNA and protein levels of Aire. Moreover, large-scale transcriptome analysis showed the modulation of 311 downstream mRNAs, which included 58 TRA mRNAs. Moreover, miR-155 mimic-transfected cells exhibited a decrease in their chemotaxis property compared with control thymocytes., Conclusion: Overall, the results indicate that miR-155 may posttranscriptionally control Aire mRNA, reducing the respective Aire protein levels; consequently, the levels of mRNAs encode tissue-restricted antigens were affected. In addition, miR-155 regulated a crucial process by which mTECs allow thymocytes' migration through chemotaxis., (© 2022. The Author(s).)

The autoimmune regulator (Aire) gene in medullary thymic epithelial cells (mTECs) encodes the AIRE protein, which interacts with its partners within the nucleus. This "Aire complex" induces stalled RNA Pol II on chromatin to proceed with transcription elongation of a large set of messenger RNAs and microRNAs. Considering that RNA Pol II also transcribes long noncoding RNAs (lncRNAs), we hypothesized that Aire might be implicated in the upstream control of this RNA species. To test this, we employed a loss-of-function approach in which Aire knockout mTECs were compared to Aire wild-type mTECs for lncRNA transcriptional profiling both in vitro and in vivo model systems. RNA sequencing enables the differential expression profiling of lncRNAs when these cells adhere in vitro to thymocytes or do not adhere to them as a way to test the effect of cell adhesion. Sets of lncRNAs that are unique and that are shared in vitro and in vivo were identified. Among these, we found the Aire-dependent lncRNAs as for example, Platr28, Ifi30, Morrbid, Malat1, and Xist. This finding represents the first evidence that Aire mediates the transcription of lncRNAs in mTECs. Microarray hybridizations enabled us to observe that temporal thymocyte adhesion modulates the expression levels of such lncRNAs as Morrbid, Xist, and Fbxl12o after 36 h of adhesion. This finding shows the existence of a synergistic mechanism involving a link between thymocyte adhesion, Aire, and lncRNAs in mTECs that might be important for immune self-representation., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Arboviral diseases are a threat to global public health systems, with recent data suggesting that around 40% of the world's population is at risk of contracting arboviruses. The use of mosquito repellents is an appropriate strategy to avoid humans coming into contact with vectors transmitting these viruses. However, the cost associated with daily applications of repellents can make their use unfeasible for the low-income populations that most need protection. Therefore, the development of effective formulations offers a way to expand access to this means of individual protection. Consequently, research efforts have focused on formulations with smaller quantities of active agents and sustained release technology, aiming to reduce re-applications, toxicity, and cost. The present study investigates the development of nanostructured lipid carriers (NLCs) loaded with a mixture of the compounds icaridin (synthetic) and geraniol (natural), incorporated in cellulose hydrogel. The NLCs were prepared by the emulsion/solvent evaporation method and were submitted to physicochemical characterization as a function of time (at 0, 15, 30, and 60 days). The prepared system presented an average particle size of 252 ± 5 nm, with encapsulation efficiency of 99% for both of the active compounds. The stability profile revealed that the change of particle size was not significant ( p > 0.05), indicating high stability of the system. Rheological characterization of the gels containing NLCs showed that all formulations presented pseudoplastic and thixotropic behavior, providing satisfactory spreadability and long shelf life. Morphological analysis using atomic force microscopy (AFM) revealed the presence of spherical nanoparticles (252 ± 5 nm) in the cellulose gel matrix. Permeation assays showed low fluxes of the active agents through a Strat-M ® membrane, with low permeability coefficients, indicating that the repellents would be retained on the surface to which they are applied, rather than permeating the tissue. These findings open perspectives for the use of hybrid formulations consisting of gels containing nanoparticles that incorporate repellents effective against arthropod-borne virus. These systems could potentially provide improvements considering the issues of effectiveness, toxicity, and safety., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Abrantes, Rogerio, de Oliveira, Campos, de Araújo, Pampana, Duarte, Valadares and Fraceto.)

Aire is a transcriptional controller in medullary thymic epithelial cells (mTECs) modulating a set of peripheral tissue antigens (PTAs) and non-PTA mRNAs as well as miRNAs. Even miRNAs exerting posttranscriptional control of mRNAs in mTECs, the composition of miRNA-mRNA networks may differ. Under reduction in Aire expression, networks exhibited greater miRNA diversity controlling mRNAs. Variations in the number of 3'UTR binding sites of Aire-dependent mRNAs may represent a crucial factor that influence the miRNA interaction. To test this hypothesis, we analyzed through bioinformatics the length of 3'UTRs of a large set of Aire-dependent mRNAs. The data were obtained from existing RNA-seq of mTECs of wild type or Aire-knockout (KO) mice. We used computational algorithms as FASTQC, STAR and HTSEQ for sequence alignment and counting reads, DESEQ2 for the differential expression, 3USS for the alternative 3'UTRs and TAPAS for the alternative polyadenylation sites. We identified 152 differentially expressed mRNAs between these samples comprising those that encode PTAs as well as transcription regulators. In Aire KO mTECs, most of these mRNAs featured an increase in the length of their 3'UTRs originating additional miRNA binding sites and new miRNA controllers. Results from the in silico analysis were statistically significant and the predicted miRNA-mRNA interactions were thermodynamically stable. Even with no in vivo or in vitro experiments, they were adequate to show that lack of Aire in mTECs might favor the downregulation of PTA mRNAs and transcription regulators via miRNA control. This could unbalance the overall transcriptional activity in mTECs and thus the self-representation., (Copyright © 2020 Oliveira, Assis, Speck-Hernandez, Duarte and Passos.)

Objective  The auditory brain stem implant (ABI) is a neuroprosthesis placed on the surface of the cochlear nucleus (CN) to provide hearing sensations in children and adults who are not candidates for cochlear implantation. Contemporary ABI arrays are stiff and do not conform to the curved brain stem surface. Recent advancements in microfabrication techniques have enabled the development of flexible surface arrays, but these have only been applied in animal models. Herein, we measure the surface curvature of the human CN and adjoining regions to assist in the design and placement of next-generation conformable clinical ABI arrays. Three-dimensional (3D) reconstructions from ultrahigh T1-weighted brain magnetic resonance imaging (MRI) sequences and histologic reconstructions based on postmortem adult human brain stem specimens were used. Design  This is a retrospective review of radiologic data and postmortem histologic axial sections. Setting  This is set at the tertiary referral center. Participants  Data were acquired from healthy adults. Main Outcome Measures  The main outcome measures are principal curvature values (Kmin and Kmax) and global radius of curvature. Results  The CN was successfully extracted and rendered as a 3D surface in all cases. Significant curvatures of the CN in both histologic and radiographic reconstructions were found with global radius of curvature ranging from 2.08 to 8.5 mm. In addition, local curvature analysis revealed that the surface is highly complex. Conclusion  Detailed rendering of the human CN is feasible using histology and 3D MRI reconstruction and highlights complex surface topography that is not recapitulated by contemporary stiff ABI arrays., Competing Interests: Conflict of Interest None delcared., (© Thieme Medical Publishers.)

Mesenchymal stem cells (MSCs) have been used in therapies for bone tissue healing. The aim of this study was to investigate the effect of cell source and osteoblast differentiation on gene expression profiles of MSCs from bone marrow (BM-MSCs) or adipose tissue (AT-MSCs) to contribute for selecting a suitable cell population to be used in cell-based strategies for bone regeneration. BM-MSCs and AT-MSCs were cultured in growth medium to keep MSCs characteristics or in osteogenic medium to induce osteoblast differentiation (BM-OBs and AT-OBs). The transcriptomic analysis was performed by microarray covering the entire rat functional genome. It was observed that cells from bone marrow presented higher expression of genes related to osteogenesis, whereas cells from adipose tissue showed a higher expression of genes related to angiogenesis and adipocyte differentiation, irrespective of cell differentiation. By comparing cells from the same source, MSCs from both sources exhibited higher expression of genes involved in angiogenesis, osteoblast differentiation, and bone morphogenesis than osteoblasts. The clustering analysis showed that AT-OBs exhibited a gene expression profile closer to MSCs from both sources than BM-OBs, suggesting that BM-OBs were in a more advanced stage of differentiation. In conclusion, our results suggest that in cell-based therapies for bone regeneration AT-MSCs could be considered for angiogenic purposes, whereas BM-MSCs and osteoblasts differentiated from either source could be better for osteogenic approaches., (© 2019 Wiley Periodicals, Inc.)

We show that chemistry can be used to trigger a nanofaceting transition. In particular, the segregation of Ag to an asymmetric tilt grain boundary in Cu is investigated. Aberration-corrected electron microscopy reveals that annealing the bicrystal results in the formation of nanometer-sized facets composed of preferentially Ag-segregated symmetric Σ5{210} segments and Ag-depleted {230}/{100} asymmetric segments. Our observations oppose an anticipated trend to form coarse facets. Atomistic simulations confirm the nanofacet formation observed in the experiment and demonstrate a concurrent grain boundary phase transition induced by the anisotropic segregation of Ag.

Objective: Evaluate the relationship between objective audiometric and vestibular tests and patient symptoms in superior canal dehiscence (SCD) syndrome., Study Design: Retrospective chart review., Setting: Tertiary care center., Patients: Ninety-eight patients with SCD, preoperative threshold audiograms, cervical vestibular evoked myogenic potential (cVEMP) thresholds, and computed tomography (CT) imaging were included. Clinical reports were reviewed for self-reported SCD symptoms. Twenty-five patients completed the Hearing Handicap Inventory (HHI), Dizziness Handicap Inventory (DHI), Autophony Index (AI), and the 36-item Short Form Survey (SF-36)., Main Outcome Measures: Correlations between preoperative low-frequency air-bone gap (ABG), cVEMP thresholds, and symptoms (including HHI, DHI, AI, and SF-36). Symptoms included hearing loss, aural fullness, autophony, hyperacusis, tinnitus, vertigo, imbalance and sound-, pressure and exercise provoked dizziness. Secondary outcome measure: Correlations between changes of objective and subjective measures before and after surgery., Results: Patients who reported hearing loss had larger ABGs at 250 Hz than patients without subjective hearing loss (p = 0.001). ABGs and cVEMP thresholds did not correlate with any other symptom. No significant correlation was found between ABG or cVEMP threshold and the HHI, DHI, AI or Health Utility Value (derived from the SF-36 quality of life score). Following SCD surgery, ABG decreased (p < 0.001), cVEMP thresholds increased (p < 0.001) and overall symptoms, handicap scores and quality-of-life improved; however, there was no significant relationship between these measures., Conclusion: While threshold audiometry and cVEMP are important tools to diagnose SCD and monitor surgical outcomes, these measures showed no significant correlation with vestibular and most auditory symptoms or their severity.

Optogenetics is a transformative technology based on light-sensitive microbial proteins, known as opsins, that enable precise modulation of neuronal activity with pulsed radiant energy. Optogenetics has been proposed as a means to improve auditory implant outcomes by reducing channel interaction and increasing electrode density, but the introduction of opsins into cochlear spiral ganglion neurons (SGNs) in vivo has been challenging. Here we test opsin delivery using a synthetically developed ancestral adeno-associated virus (AAV) vector called Anc80L65. Wild-type C57BL/6 mouse pups were injected via the round window of cochlea with Anc80L65 carrying opsin Chronos under the control of a CAG promoter. Following an incubation of 6-22 weeks, pulsed blue light was delivered to cochlear SGNs via a cochleosotomy approach and flexible optical fiber. Optically evoked auditory brainstem responses (oABRs) and multiunit activity in inferior colliculus (IC) were observed. Post-experiment cochlear histology demonstrated opsin expression in SGNs (mean = 74%), with an even distribution of opsin along the cochlear basal/apical gradient. This study is the first to describe robust SGN transduction, opsin expression, and optically evoked auditory electrophysiology in neonatal mice. Ultimately, this work may provide the basis for a new generation of cochlear implant based on light., (Copyright © 2018 The American Society of Gene and Cell Therapy. Published by Elsevier Inc. All rights reserved.)

Background: No studies that have measured the role of nursing care plans in patients with poorly controlled type 2 diabetes mellitus. Our objectives were firstly, to evaluate the effectiveness of implementing Standardized languages in Nursing Care Plans (SNCP) for improving A1C, blood pressure and low density lipoprotein cholesterol (ABC goals) in patients with poorly controlled type 2 diabetes mellitus at baseline (A1C ≥7%, blood pressure ≥ 130/80 mmHg, and low-density lipoprotein cholesterol≥100 mg/dl) compared with Usual Nursing Care (UNC). Secondly, to evaluate the factors associated with these goals., Methods: A four-year prospective follow-up study among outpatients with type 2 diabetes mellitus: We analyzed outpatients of 31 primary health centers (Madrid, Spain), with at least two A1C values (at baseline and at the end of the study) who did not meet their ABC goals at baseline. A total of 1916 had A1C ≥7% (881 UNC versus 1035 SNCP). Two thousand four hundred seventy-one had systolic blood pressure ≥ 130 mmHg (1204 UNC versus 1267 SNCP). One thousand one hundred seventy had diastolic blood pressure ≥ 80 mmHg (618 UNC versus 552 SNCP); and 2473 had low-density lipoprotein cholesterol ≥100 mg/dl (1257 UNC versus 1216 SNCP). Data were collected from computerized clinical records; SNCP were identified using NANDA and NIC taxonomies., Results: More patients cared for using SNCP achieved in blood pressure goals compared with patients who received UNC (systolic blood pressure: 29.4% versus 28.7%, p = 0.699; diastolic blood pressure: 58.3% versus 53.2%, p = 0.08), but the differences did not reach statistical significance. For A1C and low-density lipoprotein cholesterol goals, there were no significant differences between the groups. Coronary artery disease was a significant predictor of blood pressure and low-density lipoprotein cholesterol goals., Conclusions: In patients with poorly controlled type 2 diabetes mellitus, there is not enough evidence to support the use of SNCP instead of with UNC with the aim of helping patients to achieve their ABC goals. However, the use of SNCP is associated with a clear trend of a achievement of diastolic blood pressure goals.

Objective: Otogenic brain abscesses are one of the most significant life-threatening complications of otologic infections. Given their low prevalence, otogenic brain abscesses require a high index of suspicion for diagnosis. In this systematic review, we aim to provide an analysis of otogenic brain abscesses and describe common clinical signs and symptoms, bacteriology, location, treatment options, morbidity, and mortality., Data Sources: PubMed, Cochrane CENTRAL database, Google Scholar, and Scopus., Methods: A systematic review of literature was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses recommendations. Variables assessed included clinical signs and symptoms, bacteriology, location, treatment, morbidity, and mortality., Results: Twenty-nine studies met inclusion and exclusion criteria, corresponding to a total of 1307 otogenic abscess cases for review. Fifty-five percent of abscesses were found in the temporal lobe and 28% in the cerebellum. Most patients (88.3%) had a history of suppurative chronic otitis media. The most common symptoms were headache, altered mental status, papilledema, and meningeal irritation. Fever, nausea, and vomiting affected about 40% of patients. The most commonly cultured bacterial species was Proteus mirabilis . In addition to antibiotics, most otogenic brain abscesses were treated by burr hole aspiration. Average mortality following advent of computed tomography was 8.11%., Conclusion: Although rare, otogenic brain abscesses may occur as a complication of suppurative otitis media and require a high index of suspicion. Appropriate imaging studies and multidisciplinary expertise are crucial in the diagnosis and management., Level of Evidence: 4.

Oxygen contamination is a problem which inevitably occurs during severe plastic deformation of metallic powders by exposure to air. Although this contamination can change the morphology and properties of the consolidated materials, there is a lack of detailed information about the behavior of oxygen in nanocrystalline alloys. In this study, aberration-corrected high-resolution transmission electron microscopy and associated techniques are used to investigate the behavior of oxygen during in situ heating of highly strained Cu-Fe alloys. Contrary to expectations, oxide formation occurs prior to the decomposition of the metastable Cu-Fe solid solution. This oxide formation commences at relatively low temperatures, generating nanosized clusters of firstly CuO and later Fe 2 O 3 . The orientation relationship between these clusters and the matrix differs from that observed in conventional steels. These findings provide a direct observation of oxide formation in single-phase Cu-Fe composites and offer a pathway for the design of nanocrystalline materials strengthened by oxide dispersions.

Objective: Cochlear explantation for purely elective (e.g. psychological and emotional) reasons is not well studied. Herein, we aim to provide data and expert commentary about elective cochlear implant (CI) removal that may help to guide clinical decision-making and formulate guidelines related to CI explantation., Data Sources: We address these objectives via three approaches: case report of a patient who desired elective CI removal; review of literature and expert discussion by surgeon, audiologist, bioethicist, CI user and member of Deaf community., Review Methods: A systematic review using three scientific online databases was performed. Included articles addressed the benefits and/or complications of cochlear implantation in young children, CI explantation with or without revision surgery and the ethical debate between the medical and Deaf communities on cochlear implantation and explantation., Conclusions: The medical and audiological perspectives identify a host of risks related to implant removal without reimplantation, including risk from surgery, general anaesthesia, cochlear ossification and poor audiometric outcomes. The member of the deaf community and bioethicist argue that physicians need to guide the principles of beneficence, non-maleficence and patient autonomy. Taken together, patient desires should be seen as paramount, if the patient is otherwise fit for surgery and well informed., Implications for Practice: Similar to the case of device implantation, device explantation should be a multidisciplinary and collaborative decision with the patient and the family's desires at the centre. While every case is different, we offer a CI explantation discussion to assist in clinical decision-making, patient counselling and education., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Objective: To develop a novel approach combining low-frequency air-bone gap (ABG) and cervical vestibular evoked myogenic potential (cVEMP) thresholds to improve screening for superior canal dehiscence (SCD) syndrome., Study Design: Retrospective study., Setting: Tertiary care center., Patients: One hundred forty patients with SCD and 21 healthy age-matched controls were included. Ears for each patient were divided into three groups based on computed tomography (CT) findings: 1) dehiscent, 2) thin, or 3) unaffected., Main Outcome Measures: cVEMP and audiometric thresholds were analyzed and differences among groups were evaluated., Results: We define the third window indicator (TWI) as the cVEMP thresholds at 500, 750, and 1000 Hz adjusted for the ABG at 250 Hz (i.e., subtracting ABG from cVEMP threshold). The TWI differentiates between dehiscent and nondehiscent control ears with a sensitivity of 82% and specificity of 100%, corresponding to a positive predictive value of 100%. ABGs and cVEMP thresholds were similar for healthy controls and patients with thin bone over the superior canal., Conclusion: This is the largest study to date examining the usefulness of cVEMPs in the diagnosis of SCD. Our "third window indicator" (TWI) combines cVEMP thresholds with the ABG at 250 Hz to improve the ability to screen patients with SCD symptoms.

Objective: Otologic methicillin-resistant Staphylococcus aureus (MRSA) infection has historically been rare, but given the rise in community-acquired MRSA carriage and infection at other body sites, prevalence rates may be changing. The goal of this study was to determine the prevalence of MRSA in recent otologic cultures from patients with acute otitis externa (AOE)., Study Design: Retrospective review of an institutional microbiologic database., Methods: A retrospective analysis was performed on serial culture isolates taken from the ear at a quaternary care hospital from January 2014 to April 2016. The causative pathogen and antibiotic sensitivity was determined by culture isolation and end point mean inhibitory concentration (MIC) testing. Medical records were reviewed to document patient characteristics, chronicity of infection, symptomatology, and previous treatments., Results: Over the study period, 173 patients were diagnosed with AOE and underwent otologic cultures of the ear. Fifty-three (30.6%) of cultures grew S . aureus (SA). Of SA infections, 15 (28.3%) were identified as MRSA. MRSA patients were typically older than patients with methicillin-sensitive SA (MSSA) (mean age 46.7 ± 17.9 vs 29 ± 19.4, P  = 0.003) and had more medical comorbidities (4 vs 1.7, P  = 0.001). Compared to patients with MSSA, patients with MRSA were significantly more likely to have had prior ototopical antibiotic exposure (37% vs 73%, P  = 0.019)., Conclusion: Contemporary ear culture isolates at quaternary care center show higher rates of MRSA compared to historical reports in the literature. Clinicians should consider ear cultures to identify MRSA AOE., Level of Evidence: IV.

On page 4877, F. U. Renner, A. Bashir, M. Valtiner, and co-workers describe a star-like dealloying corrosion morphology that appears during the localized attack of smooth well-prepared Cu-Au surfaces. The surfaces are initially protected by thiol or selenol inhibitior films. Localized dealloying of Cu-Au produces nanoporous gold under stress and crystallographic cracks - thereby opening a new approach combining surface science with nanoscale mechanical testing., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

On self-assembled monolayer-covered Cu-Au substrates, localized volume shrinkage at initial dealloying sites leads to cracks within the attacked regions. It is started from well-controlled surface structures to gain fundamental insights in the driving mechanisms of localized corrosion and crack formation. Both the crack density and the crack morphology are critically dependent on surface orientation, crystallography, and inhibitor molecule species., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

In Brazil, abortion is permitted by law in cases of rape-related pregnancy. This study reports on various aspects in the experience of women that have been sexually assaulted: diagnosis of the pregnancy, seeking legal abortion, and hospitalization in a university hospital. This was a qualitative study that interviewed ten women 18 to 38 years of age, with at least eight years of schooling, one to five years after legal abortion. The women had been previously unaware of their right to a legal abortion, were ashamed about the sexual assault, kept it secret, and had not sought immediate care. The diagnosis of pregnancy provoked anxiety and the wish to undergo an abortion. Women treated through private health plans received either insufficient orientation or none at all. Respectful treatment by the healthcare staff proved relevant for the women to cope with the abortion. The study highlights the need to publicize the right to abortion in cases of rape-related pregnancy and the healthcare services that perform legal abortion, in addition to training healthcare and law enforcement teams to handle such cases.

Little is known about public perspectives of scientific and therapeutic uses of placentas. Gaps in knowledge potentiate ethical and clinical problems regarding collection and applications. As such, this study sought to assess the perspectives of placenta donation of a sample of women. Postpartum women's perspectives on placental donation were assessed at the State University of Campinas in the Centro de Atençäo Integral a Saúde da Mulher (CAISM) maternity hospital using a cross-sectional survey (n = 384) and semi-structured interviews (n = 12). Surveys were analyzed quantitatively and interviews were analyzed qualitatively using grounded coding; results were compared. The average age of respondents was 27. Fifty-six percent had more than one child, 45% were Caucasian, 38% were mixed-race, 74% identified with a Christian faith, 52% had high school education or higher, 13% regarded the placenta as spiritually important, 72% felt that knowing what happens to the placenta after birth was somewhat or very important, 78% supported the use of the placenta in research and medicine, 59% reported that consent to collect the placenta was very or somewhat important, 78% preferred their doctor to invite donation, and only 7% preferred the researcher to invite donation. Interviews suggested women appreciate being part of research and that receiving information about studies was important to them. Informed by these results, we argue that women support scientific and therapeutic uses of placentas, want to be included in decision making, and desire information about the placenta. Placentas should not be viewed as "throwaway" organs that are poised for collection without the involvement and permission of women. Women want to be meaningfully included in research processes., (© The Author(s) 2014.)

Objective: To evaluate the proportion of health services that fill out the compulsory notification and what the main difficulties to fill it out are., Methods: A study was carried out with two different approaches. For the quantitative approach, a cross sectional study was performed, with telephone data collection. In the state of São Paulo, 291 health services that had reported providing care to women who suffer from sexual violence were identified. The sample was composed of 172 services that reported providing emergency care to women. In the qualitative approach, case studies were conducted. Six cities were chosen by intention and convenience. For each of them, professionals from two health services were invited to participate. Forty-five semi-structured interviews were conducted. For quantitative data, a descriptive analysis was carried out. For qualitative data, a thematic analysis of content was performed., Results: The proportion of health services which reported always filling out the notification in cases of sexual violence was 79.1%. More than half (53.5%) reported difficulties concerning the assisted women, one third reported reasons related to the form, and 29.7%, to the professionals. In the qualitative approach, the main difficulties were the size of the form, the problems to obtain the information about the woman and the difficulty for the professional to obtain this information., Conclusion: Although most health services claimed to fill out the compulsory notification, they also mentioned several difficulties to do so, especially with regard to the workload of professionals and the misunderstanding about the importance of the notification in the context of comprehensive care to women who suffer from sexual violence., Objective: To evaluate the proportion of health services that fill out the compulsory notification and what the main difficulties to fill it out are., Methods: A study was carried out with two different approaches. For the quantitative approach, a cross sectional study was performed, with telephone data collection. In the state of São Paulo, 291 health services that had reported providing care to women who suffer from sexual violence were identified. The sample was composed of 172 services that reported providing emergency care to women. In the qualitative approach, case studies were conducted. Six cities were chosen by intention and convenience. For each of them, professionals from two health services were invited to participate. Forty-five semi-structured interviews were conducted. For quantitative data, a descriptive analysis was carried out. For qualitative data, a thematic analysis of content was performed., Results: The proportion of health services which reported always filling out the notification in cases of sexual violence was 79.1%. More than half (53.5%) reported difficulties concerning the assisted women, one third reported reasons related to the form, and 29.7%, to the professionals. In the qualitative approach, the main difficulties were the size of the form, the problems to obtain the information about the woman and the difficulty for the professional to obtain this information., Conclusion: Although most health services claimed to fill out the compulsory notification, they also mentioned several difficulties to do so, especially with regard to the workload of professionals and the misunderstanding about the importance of the notification in the context of comprehensive care to women who suffer from sexual violence.

Background: The Brazilian Network for the Surveillance of Severe Maternal Morbidity was developed in Brazil with the participation of 27 centers in different regions of the country. The objective of the network project was to evaluate the frequency of severe maternal morbidity (near-miss and potentially life-threatening conditions) and the factors involved with these clinical conditions. Over the data collection period, this project implemented a surveillance system to identify these cases in the participating institutions. The objective of the present study was to evaluate the perspective of the professionals who participated in this network regarding the surveillance of cases of severe maternal morbidity, the facilities and difficulties encountered in involving colleagues in the process, and participants’ proposals to give continuity to this practice of qualifying maternal healthcare., Methods: A descriptive study with a qualitative approach was conducted in which coordinators, investigators and managers at all the 27 obstetric units participating in the network were interviewed. Data were collected at 6 and 12 months after implementation of the network during semi-structured telephone interviews that were recorded following verbal informed consent. Thematic content analysis was performed of the responses to the open questions in the interviews., Results: In the opinion of 60% of the participants, involving their colleagues in the surveillance process proved difficult, principally because these professionals were not very interested in the research project, but also because they found it difficult to review concepts and professional practices, because they had an excessive workload or due to operational and technical difficulties. The great majority considered that support from government agencies providing financial resources would be crucial to enable surveillance to be maintained or expanded and also to train a larger number of professionals and improve work conditions. The majority of participants found it difficult to define the ideal time interval at which surveillance should be conducted., Conclusion: The investigators, coordinators and managers involved in the Brazilian network project mentioned several problems that had to be confronted during this process; however, in their opinion the project should be maintained and even expanded in view of its potential to contribute towards improving obstetric care.

Pigmented tooth enamel occurs in several vertebrate clades, ranging from mammals to fish. Although an iron compound is associated with this orange to red colored pigmentation, its chemical and structural organization within the enamel is unknown. To determine the nature of the iron compound, we investigated heavily pigmented teeth of the northern short-tailed shrew Blarina brevicauda using combined characterization techniques such as scanning and transmission electron microscopy and synchrotron X-ray diffraction. We found that the pigmentation of the enamel with an iron content of around 8wt% results from a close to amorphous magnetite phase deposited around the nm-sized enamel crystals. Furthermore, the influence of the pigmentation on the enamel hardness was determined by nanoindentation measurements. Finally, the biomechanical function and biological context are discussed in light of the obtained results., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: The Brazilian Network for Surveillance of Severe Maternal Morbidity was established in 27 centers in different regions of Brazil to investigate the frequency of severe maternal morbidity (near-miss and potentially life-threatening conditions) and associated factors, and to create a collaborative network for studies on perinatal health. It also allowed interventions aimed at improving the quality of care in the participating institutions. The objective of this study was to evaluate the perception of the professionals involved regarding the effect of participating in such network on the quality of care provided to women., Methods: A mixed quantitative and qualitative study interviewed coordinators, investigators and managers from all the 27 obstetric units that had participated in the network. Following verbal informed consent, data were collected six and twelve months after the surveillance period using structured and semi-structured interviews that were conducted by telephone and recorded. A descriptive analysis for the quantitative and categorical data, and a thematic content analysis for the answers to the open questions were performed., Results: The vast majority (93%) of interviewees considered it was important to have participated in the network and 95% that their ability to identify cases of severe maternal morbidity had improved. They also considered that the study had a positive effect, leading to changes in how cases were identified, better organization/standardization of team activities, changes in routines/protocols, implementation of auditing for severe cases, dissemination of knowledge at local/regional level and a contribution to local and/or national identification of maternal morbidity. After 12 months, interviewees mentioned the need to improve prenatal care and the scientific importance of the results. Some believed that there had been little or no impact due to the poor dissemination of information and the resistance of professionals to change practice. In this second interview, a lack of systematic surveillance after the end of the study, difficulty in referring cases and changes in the leadership of the unit were mentioned., Conclusion: In the opinion of these professionals, participating in a network for the surveillance of severe maternal morbidity represented a good strategy for improving services, even in reference centers.

Objective: To investigate knowledge of HPV and HPV vaccines in men and women, users of the Brazilian Unified Health System, and the intention to get themselves and their teenage children vaccinated., Methods: A descriptive, cross-sectional study with 286 women (18-49 years old) and 252 men (18-60 years old), users of five primary health units and two polyclinics in Campinas, SP, Southeastern Brazil, was carried out. Participants were interviewed in 2011 using a structured questionnaire. Bivariate and Poisson regression analysis were performed to identify variables associated with knowledge of HPV and HPV vaccines, and participants vaccination intentions., Results: Almost 40.0% of the participants reported having heard of HPV and 28.9% mentioned adequate information. The main information source was the media (41.7%). Only 8.6% of the participants had heard of the HPV vaccines. Once the participants were informed of the existence of HPV vaccines about 94% of them said they would get vaccinated and/or vaccinate their teenage children, if the vaccines were available in the public health system. Schooling of over 8 years and being female were the variables independently associated with having heard of HPV, the vaccines and having adequate knowledge of the virus. Advanced age was associated with having heard of HPV vaccines. There were no variables associated with the vaccination intentions., Conclusions: These results reinforce the need for educational activities that provide the population with adequate information on HPV and preventive measures.

Conscientious objection is a legitimate right of physicians to reject the practice of actions that violate their ethical or moral principles. The application of that principle is being used in many countries as a justification to deny safe abortion care to women who have the legal right to have access to safe termination of pregnancy. The problem is that, often, this concept is abused by physicians who camouflage under the guise of conscientious objection their fear of experiencing discrimination and social stigma if they perform legal abortions. These colleagues seem to ignore the ethical principle that the primary conscientious duty of OB/GYNs is-at all times-to treat, or provide benefit and prevent harm to, the patients for whose care they are responsible. Any conscientious objection to treating a patient is secondary to this primary duty. One of the jobs of the FIGO Working Group for the Prevention of Unsafe Abortion is to change this paradigm and make our colleagues proud of providing legal abortion services that protect women's life and health, and concerned about disrespecting the human rights of women and professional ethical principles., (Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Objective: This study aimed to develop and validate the contents of the Mosaico de Opiniões Sobre o Aborto Induzido (Mosai), a structured questionnaire intended to be used as a tool to collect information about the views of health professionals about the morality of abortion., Methods: The contents of the first version of the questionnaire was developed based on the technique of thematic content analysis of books, articles, films, websites and newspapers reporting cases of abortion and arguing about their practice. The Mosai was composed of 6 moral dilemmas (vignettes) related to induced abortion, whose outcomes should be chosen by the respondents and could be justified by the classification of 15 patterns of arguments about the morality of abortion. In order to validate its contents, the questionnaire was submitted to the scrutiny of a panel of 12 experts, an intentional sample consisted of doctors, lawyers, ethicists, sociologists, nurses and statisticians, who evaluated the criteria of clarity of writing, relevance, appropriateness to sample and suitability to the fields. These scores were analyzed by the method of concordance rate, while the free comments were analyzed using the analysis technique content., Results: All the moral dilemmas and arguments were considered valid according to the rate of agreement, however, some comments led to the exclusion of a dilemma about emergency contraception, among other changes., Conclusion: The content of Mosai was considered valid to serve as a tool to collect the opinions of healthcare professionals regarding the morality of abortion., (Copyright © 2013 Elsevier Editora Ltda. All rights reserved.)

Ultrathin passive films effectively prevent the chemical attack of stainless steel grades in corrosive environments; their stability depends on the interplay between structure and chemistry of the constituents iron, chromium, and molybdenum (Fe-Cr-Mo). Carbon (C), and eventually boron (B), are also important constituents of steels, although in small quantities. In particular, nanoscale inhomogeneities along the surface can have an impact on material failure but are still poorly understood. Addressing a stainless-type glass-forming Fe50Cr15Mo14C15B6 alloy and using a combination of complementary high-resolution analytical techniques, we relate near-atomistic insights into increasingly inhomogeneous nanostructures with time- and element-resolved dissolution behavior. The progressive elemental partitioning on the nanoscale determines the degree of passivation. A detrimental transition from Cr-controlled passivity to Mo-controlled breakdown is dissected atom by atom, demonstrating the importance of nanoscale knowledge for understanding corrosion.

Purpose: To evaluate the level of stress in men and women seeking treatment for infertility and to identify the associated variables., Methods: A cross-sectional study with 101 men and 101 women consulting for the first time at the Human Reproduction Unit. Participants completed the Brazilian version of the Fertility Problem Inventory (FPI) based on four domains: "social relationships", "life without children"; "marital relationship/sexual" and "maternity/paternity" and a structured questionnaire with socioeconomic and reproductive variables. Bivariate analysis was performed using the Chi-square and Fisher exact tests, considering p<0.05. Afterwards the multivariate correspondence analysis was done with variables with p<0.20., Results: Overall, the participants presented a high level of stress in all domains, except in the "life without children" domain. Multivariate analysis of correspondence showed that variables associated with a high level of stress in the "social relationships" domains were: to be a woman, to have the infertility problem, and to consider the quality of the marital relationship to be regular. In the "life without children" domain the variables that approached the high stress were: to be woman, age between 18 and 24 years, and to have the infertility problem. To be a man, to consider adoption, parents/in-laws and other people knowing about the difficulty to become pregnant, and to consider the quality of the marital relationship to be excellent were the variables associated with high level of stress in "marital/sexual relationship" domain. For "maternity/paternity" domain the variables associated were to be women, consider marital relationship quality regular, age between 25 and 35 years, be evangelical or protestant were the variables associated with a high level of stress., Conclusion: Men and women seeking treatment for infertility present a high level of stress and it can be suggested that psychosocial support is important and should be different for men and women.

Purpose: To evaluate the prevalence and factors associated with intimate partner violence (IPV) among women users of Basic Health Units (BHU) in the State of São Paulo., Methods: This was a cross-sectional descriptive study based on secondary data analysis of women users' interviews at 75 BHU in the State of São Paulo, from August/2008 to May/2009. We used a questionnaire based on the Abuse Assessment Screen and the Conflict Tactics Scales modified by the Violence Against Women Study (VAW), structured and pre-tested. The variables studied were the types of IPV (psychological, physical and sexual) and sociodemographic variables (age, education, race, paid work, religion, marital status and economic class). We interviewed 2,379 women aged 18 to 60 years., Results: The prevalence of lifetime IPV was 55.7%, and the prevalences of psychological, physical and sexual IPV were 53.8, 32.2 and 12.4%, respectively. Women without a partner but previously married, with schooling <8 years and belonging to the lower economic class had a higher risk for all types of IPV, and other factors were also associated with psychological and sexual IPV., Conclusions: The prevalence of IPV is high. Healthcare professionals in primary care should make an attempt to detect IPV.

This study compares both versions of the nutritional requirement system determined by the National Research Council (NRC) version 1985 (NRC85) and NRC version 2007 (NRC07), for finishing lambs in feedlots. Nineteen crossbred lambs were divided in four groups representing four experimental treatments: one diet according to NRC85 and three diets according to NRC07. The diets recommended by NRC07 considers crude protein intake relative to ruminal undegradable protein at 20, 40, and 60 % levels (NRC07/20, NRC07/40, and NRC07/60). Diets were composed of Brazilian semi-arid native grass silage, soybean meal, corn, annatto byproduct, and limestone. Purchases and sales of lambs were done according to average market prices in Brazil. The economic indicators considered pointed that all treatments were viable but NRC07/20 and NRC07/60 were more profitable with similar net present values (NPVs) and internal return rates (IRRs). NRC07/20 was the best option showing an IRR of 17.20 % and a payback period (PP) of 5.07 considering a fixed annual interest rate of 6 %. Sensitivity analysis considering a 10 % raise in variable costs showed negative NPVs, IRRs inferior to the opportunity cost rates adopted and PPs that exceeded the planning horizon of 7 years for both NRC85 and NRC07/40.

Objective: To estimate the prevalence of violence in women who are primary healthcare users and to verify if these situations were detected and how they were tackled by these services' professionals., Methods: Descriptive, cross-sectional study carried out with 14 municipal women's health coordinators, 2,379 women who are users of primary healthcare units, 75 managers and 375 professionals, in 15 municipalities of the State of São Paulo (Southeastern Brazil), between August 2008 and May 2009. Data were collected through structured questionnaires and a descriptive analysis was conducted., Results: A specific protocol for assisting women in situations of violence was mentioned in five municipalities. The majority (83%) of the coordinators reported that situations of violence among female users were detected, although 74% said this was not routinely investigated, which was confirmed by 72.3% of the professionals. Among the women, 76.5% reported having experienced some type of violence throughout their lives, and 56.4% said that an intimate partner was the perpetrator of that violence; almost 30% reported at least one episode in the 12 months prior to the interview; 6.5% reported looking for help at a Primary Healthcare Unit., Conclusions: A relevant proportion of users experienced violence in their daily routine, mainly perpetrated by an intimate partner. Most of the women were neither identified nor approached in these services and did not receive help. Although health managers and professionals realized the magnitude of the problem, they did not consider that primary care was prepared to assist these women. The study showed that there is no intersectoral care network to assist women in situation of violence.

Introduction: Female sexual function depends on biological, psychological, and sociocultural contexts., Aim: The objective of the present study was to evaluate the prevalence of low levels of functioning in each of the sexual function domains (desire, arousal, and orgasm) and the factors associated with these phenomena, as well as to assess the frequency of sexual activity in this same sample population., Methods: A cross-sectional, population-based study was conducted using an anonymous self-response questionnaire completed by 378 Brazilian-born women of 40-65 years of age with 11 years or more of formal education. The evaluation instrument was based on the Short Personal Experiences Questionnaire., Results: The prevalence of low sexual desire was 60.6%; low arousal, 37%; and low orgasmic function, 31.1%. Multiple regression analysis showed that having a sexual partner (prevalence ratio [PR] = 0.69, confidence interval [CI] = 0.53-0.90) and nervousness (PR = 1.33, CI = 1.01-1.75) were factors associated with low sexual desire. Aging (PR = 1.04, CI = 1.02-1.06), having a sexual partner (PR = 0.57, CI = 0.41-0.81), feeling well/excellent (PR = 0.59, CI = 0.41-0.85), and having hot flashes (PR = 1.47, CI = 1.01 = 2.15) were factors found to be associated with low sexual arousal. Having a sexual partner (PR = 0.55, CI = 0.42-0.71), feeling well/excellent (PR = 0.68, CI = 0.49-0.94), and having hot flashes (PR = 2.08, CI = 1.43 = 3.04) were factors found to be associated with low sexual orgasmic function. Having a sexual partner (PR = 0.47, CI = 0.38-0.58), feeling well/excellent (PR = 0.78, CI = 0.69-0.89), and having hot flashes (PR = 1.15, CI = 1.05-1.26) were factors found to be associated with a frequency of sexual activity of once a week or less., Conclusions: In this sample of middle-aged women, low sexual desire was the most prevalent sexual problem. These results highlight the importance of identifying and treating factors associated with each individual component of low female sexual function., (© 2011 International Society for Sexual Medicine.)

The objective of this study was to evaluate the feasibility of using computer assisted telephone interviewing (CATI) as a method for obtaining information on reproductive health in Brazil. A total of 998 eligible women for the study were selected to answer a questionnaire through computer- assisted telephone interviewing undertaken by trained interviewers. The outcomes of each telephone contact attempt were described. Differences between groups were assessed using the χ(2) test. Phone contact was made in 60.3% of the attempts and 57.5% of the interviews were completed. The success rate improved with the decrease in time from hospitalization to interview and with the higher numbers of telephones available. A total of 2,170 calls were made, comprising of one to sixteen attempts per woman. The majority of situations where extra calls were necessary were due to the number being busy or to the fact that the woman was not available at the time of the call. CATI can prove be a valuable procedure for obtaining information on reproductive health among Brazilian women, particularly for relatively recent events and when more than one alternative telephone number is available.

This pilot study aimed to identify the effects of a 6-month, multimodal exercise program on clinical and gait parameters in patients with Parkinson's disease. Two groups of participants were enrolled in the study: Trained Group (TG) and Control Group (CG). Individuals in the TG exercised three times a week for 24 weeks (in a multimodal exercise program), while the CG participants maintained their regular activity level. Participants in both the TG and the CG were assessed at pre- and posttest by clinical rates and the spatiotemporal parameters of self-paced walking. The two groups were not significantly different in demographic, clinical, and gait data at baseline. There were no significant differences between groups for clinical data at posttest. The purposed multimodal exercise program has found improvement in some kinematic gait parameters for the TG. Further study in the form of randomized controlled trial would be required to establish effectiveness of the intervention.

Objective: To analyze the opinion of judges and prosecutors concerning Brazilian abortion law and situations in which the abortion should be allowed., Methods: A cross-sectional study was performed with 1,493 judges and 2,614 prosecutors in Brazil between 2005 and 2006. Participants completed a structured questionnaire approaching sociodemographic characteristics, opinions about abortion law, and circumstances in which abortion is considered lawful. Bivariate and multivariate analyses of data were carried out through Poisson regression., Results: The majority of participants (78%) found that the circumstances in which abortion is considered lawful should be broadened, or even that abortion should not be criminalized. The highest rates of pro-abortion opinions resulted from: risk to the life of the mother (84%), anencephaly (83%), severe congenital malformation of fetus (82%), and pregnancy resulting from rape (82%). Variables related to religion were strongly associated to the opinion of participants., Conclusions: There is a trend in considering the need of changing the current abortion law, in the sense of widening the circumstances in which abortion is considered lawful, or even toward decriminalizing abortion, regardless of the circumstances in which it takes place.