Search

Background: Acute variceal bleeding (AVB), a life-threatening complication of liver cirrhosis, can be effectively treated by endoscopy, but there is a risk of early rebleeding after endoscopic variceal treatment (EVT). Thrombocytopenia is the most common hemostatic abnormality in liver cirrhosis. However, it is still unclear about whether thrombocytopenia increases the failure of EVT in cirrhotic patients with AVB., Objectives: We investigated the association between thrombocytopenia and the failure of EVT in cirrhotic patients with AVB., Design: International multicenter, retrospective study., Methods: Overall, 2467 cirrhotic patients with acute gastrointestinal bleeding who were enrolled into an international multicenter study between September 30, 2020 and June 30, 2023 were retrospectively screened. Thrombocytopenia was defined as platelet count below 150 × 10 9 /L and further classified as mild (100 × 10 9 /L-150 × 10 9 /L), moderate (50 × 10 9 /L-100 × 10 9 /L), and severe (<50 × 10 9 /L). A 1:1 propensity score matching (PSM) analysis was performed. Five-day failure to control bleeding was evaluated., Results: Overall, 1079 patients were included, of whom 923 (85.5%) had thrombocytopenia, including mild ( n  = 241), moderate ( n  = 445), and severe ( n  = 237) thrombocytopenia. PSM analysis demonstrated that the rate of 5-day failure to control bleeding was not significantly different between patients with and without thrombocytopenia (mild: (12/153) 7.8% vs (7/153) 4.6%, p  = 0.236; moderate: (9/155) 5.8% vs (7/155) 4.5%, p  = 0.608; or severe: (5/132) 3.8% vs (7/132) 5.3%, p  = 0.555)., Conclusion: Thrombocytopenia may not influence the efficacy of EVT in cirrhotic patients with AVB., Competing Interests: The authors declare that there is no conflict of interest., (© The Author(s), 2025.)

We report the genomic analysis from early equine cases of the Western equine encephalitis virus outbreak during 2023-2024 in Uruguay. Sequences are related to a viral isolate from an outbreak in 1958 in Argentina. A viral origin from South America or continuous enzootic circulation with infrequent spillover is possible.

The incorporation of residues in cement matrices is a viable alternative for obtaining new products for civil construction and a sustainable solution for the disposal of materials discarded by industries. In this context, the objective of the study was to evaluate the potential use of quartzite and particles of Hevea brasiliensis in the production of cement-wood panels. Quartzite residues and Hevea brasiliensis wood particles were obtained and characterized. The panels were produced with CPV-ARI Portland cement, 4% calcium chloride (CaCl 2 ) in relation to cement mass, treated wood particles, and replacing cement with quartzite in different proportions (0, 10, 20, and 40%), totaling four treatments. The physical-mechanical and microstructural properties of the panels were determined. Replacing cement with 10 and 20% quartzite contributed to the improvement in water absorption and thickness swelling, and due to increased density, MOE and MOR also increased with 20% quartzite. The cement-wood panels were suitable for non-structural and internal use, requiring further studies to evaluate alternative methods of replacing these residues., Competing Interests: Declarations. Ethics approval: The authors’ participation was authorized during the construction of the study. Consent for publication: All authors agree with the publication of the article in this journal. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The Brazilian western Amazon is experiencing its largest laboratory-confirmed Oropouche virus (OROV) outbreak, with more than 6,300 reported cases between 2022 and 2024. In this study, we sequenced and analyzed 382 OROV genomes from human samples collected in Amazonas, Acre, Rondônia and Roraima states, between August 2022 and February 2024, to uncover the origin and genetic evolution of OROV in the current outbreak. Genomic analyses revealed that the upsurge of OROV cases in the Brazilian Amazon coincides with spread of a novel reassortant lineage containing the M segment of viruses detected in the eastern Amazon region (2009-2018) and the L and S segments of viruses detected in Peru, Colombia and Ecuador (2008-2021). The novel reassortant likely emerged in the Amazonas state between 2010 and 2014 and spread through long-range dispersion events during the second half of the 2010s. Phylodynamics reconstructions showed that the current OROV spread was driven mainly by short-range (< 2 km) movements consistent with the flight range of vectors. Nevertheless, a substantial proportion (22%) of long-range (>10 km) OROV migrations were also detected, consistent with viral dispersion by humans. Our data provide a view of the unprecedented spread and evolution of OROV in the Brazilian western Amazon region., Competing Interests: Competing interests: All authors declare that no conflicts of interest exist., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Recombination plays a crucial role in the evolution of SARS-CoV-2. The Omicron XBB* recombinant lineages are a noteworthy example, as they have been the dominant SARS-CoV-2 variant worldwide in the first half of 2023. Since November 2023, a new recombinant lineage between Omicron subvariants XBB and BA.2.86, designated XDR, has been detected mainly in Brazil. In this study, we reconstructed the spatiotemporal dynamics and estimated the absolute and relative transmissibility of the XDR lineage. The XDR lineage displayed a recombination breakpoint in the ORF1a-coding region, and the most closely related sequences to the 5' and 3' ends of the recombinant correspond to JD.1.1 and JN.1.1 lineages, respectively. The first XDR sequences were detected in November 2023 in the Northeastern Brazilian region, and their prevalence rapidly surged from <1% to 25% by February 2024. The Bayesian phylogeographic analysis supports that the XDR lineage likely emerged in the Northeastern Brazilian region around late October 2023 and rapidly disseminated within and outside Brazilian borders from mid-November onward. The median effective reproductive number of the XDR lineage in Brazil during the initial expansion phase was estimated to be around 1.5, and the average relative instantaneous reproduction numbers of XDR and JN* lineages were estimated to be 1.37 and 1.29 higher than that of co-circulating XBB* lineages. In summary, these findings support that the recombinant lineage XDR arose in the Northeastern Brazilian region in October 2023, shortly after the first detection of JN.1 sequences in the country. In Brazil, the XDR lineage exhibited a higher transmissibility level than its parental XBB.* lineages and is spreading at a rate similar to or slightly faster than the JN.1* lineages.IMPORTANCEThis study highlights the emergence and rapid dissemination of the recombinant SARS-CoV-2 XDR lineage, derived from the Omicron lineages JD.1.1 and JN.1.1. The XDR lineage exhibited equivalent transmissibility to its JN.1* parental lineages and quickly spread across Brazil in late 2023. The findings underscore the critical role of real-time genomic surveillance in detecting novel variants with higher transmission potential. By utilizing phylogenetic and epidemiological methods, this research provides important insights into the molecular dynamics of XDR, which could inform public health responses and vaccine composition updates. The study's significance lies in its ability to document the impact of recombination on viral evolution, offering valuable information to the field of virology and pandemic preparedness.

The objective of this study was to evaluate the viability of juá pulp for fermentation by monoculture L. casei (Lc - 01) and L. acidophilus (La - 05) and co-culture (25 and 37 °C) for 72 h. Viable strain values (> 7 log CFU/g), pH reduction (below 3.7), fructose and glucose and increased of lactic acid showed that the pulp of juá served as a good matrix for fermentation. Catechin, epicatechin, epigallocatechin procyanidin B1, and gallic acid were the main phenolics that contributed to antioxidant activity. Fermentation by mono or co-culture increased or reduced the content of phenolics and antioxidant activity. Results showed that culture, time and temperature have effects in the fermentation of juá pulp. The co-cultivation of La - 05 + Lc - 01 contributed to improving the bioaccessibility of gallic acid (72.9%) of the jua pulp. Finding indicate juá pulp as a promising substrate to obtaining a new probiotic plant-based fermented beverage., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Oropouche virus (OROV) is an arbovirus endemic in the Amazon region that closely resembles other arboviruses in terms of human disease, leading to potential misdiagnoses. The virus ecology has mostly restricted its occurrence to the Amazon biome; however, after a large 2023-24 OROV epidemic in the Brazilian Amazon region, outbreaks are being reported across Brazil and in other countries in Latin America. Here, we investigate the OROV spread outside Amazonia., Methods: In this genomic and epidemiological study, OROV cases from January, 2023, to July, 2024, provided by the General Coordination of Public Health Laboratories of Brazil on Aug 1, 2024, were compared by geographical location (Amazon vs non-Amazon) and municipal population size, and a linear mixed model was employed to assess the relationship between agricultural area size and cases. OROV-positive samples from central laboratories of five non-Amazonian Brazilian states were sequenced using an amplicon-based approach. Bayesian phylogeographical analysis was performed with near full-length viral genomes, incorporating individual travel histories when relevant. The estimated dates of viral introductions in each sampled location were then contextualised with public epidemiological data., Findings: Epidemic data show that outside the Amazon region, OROV cases frequency was 3·9-times higher in small municipalities than in large municipalities. The planted areas of some agricultural products, such as banana plantations, were positively correlated (r=0·39, p<0·0001) with OROV cases. The linear mixed model revealed that, besides banana, cassava also has larger (p<0·05) planted areas in municipalities with OROV cases when compared with those with no cases. The phylogenetic analysis of 32 new OROV genomes reconstructed multiple exportation events of the newly identified reassortant lineage from the Amazon to other Brazilian regions between January and March, 2024. At least three of the previously described OROV phylogenetic clades circulating in the Amazon were the source of viral introductions. Molecular clock analysis estimated that viral introductions happened from 50 days to 100 days before detecting the outbreaks in each state., Interpretation: Our results confirm that the novel OROV reassortant lineage spread from the Amazon to other regions in early 2024, successfully establishing local transmission. The fact that outbreaks were observed in small municipalities, instead of large urban centres, suggests that local ecological conditions that are ideal for OROV vector occurrence, such as the banana plantation environment, might be important factors driving its spread in Brazil., Funding: DECIT, CNPq, FAPEAM, and Inova-Fiocruz., Translation: For the Portuguese translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

Background: Endoscopy is important for the diagnosis and treatment of acute upper gastrointestinal bleeding (AUGIB), especially acute variceal bleeding (AVB), in liver cirrhosis. However, the optimal timing of endoscopy remains controversial, primarily because the currently available evidence is of poor quality, and the definition of early endoscopy is also very heterogeneous among studies. Herein, a multicenter randomized controlled trial (RCT) is performed to explore the impact of the timing of endoscopy on the outcomes of cirrhotic patients with AVB., Methods: A total of 368 cirrhotic patients presenting with AUGIB who are highly suspected to be from AVB will be enrolled. They will be stratified according to the severity of liver function and clinical presentation at admission and then randomly assigned at a 1:1 ratio into early (within 12 h after admission) and delayed (within 12-24 h after admission) endoscopy groups within each stratum. The primary outcomes include the rates of 5-day failure to control bleeding after admission and 6-week rebleeding. The secondary outcomes include 6-week mortality and incidence of adverse events., Conclusion: Considering existing evidence originates from non-randomized studies, this RCT will provide high-quality evidence to uncover whether cirrhotic patients with AVB should undergo early endoscopy to control bleeding and improve survival., Trial Registration: ClinicalTrials.gov identifier: NCT06031402., Competing Interests: The authors declare that there is no conflict of interest., (© The Author(s), 2024.)

Cellulose micro/nanofibril (MNFC) films are an interesting alternative to plastic-based films for application in biodegradable packaging. In this study, we aimed to produce and characterize MNFC films obtained from alkaline-pretreated rubberwood (Hevea brasiliensis) waste and Eucalyptus sp. commercial pulp. MNFC and films were evaluated regarding microstructure; crystallinity; stability; and physical, optical, mechanical, and barrier properties. A combined quality index (QI) was also calculated. Eucalyptus MNFC suspensions were more stable than H. brasiliensis. Both films had a hydrophobic surface (>90°) and high grease resistance (oil kit 12). H. brasiliensis films had lower transparency (26.4 %) and high crystallinity (∼89 %), while Eucalyptus films had lower permeability and higher mechanical strength. The QI of MNFC was 51 ± 5 for H. brasiliensis and 55 ± 4 for Eucalyptus, showing that both types of raw material have potential for application in the packaging industry and in the reinforcement of composites, as well as for high value-added applications in products made from special materials., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Food-packaging-processing interactions define packaging materials' performance properties and product quality. This study evaluated the effect of ohmic heating (OH) processing and different food simulants on the properties of four multilayer flexible packaging materials (PET met /PE, PET met /PP, PET/Al/PE, and PET/Al/PA/PP). OH treatment was applied to the sealed packages containing the food simulants using a voltage gradient of 3.7 V/cm at a frequency of 20 kHz, resulting in a thermal process of at 80 °C for 1 min. The structure and performance of the different packages were then evaluated. The materials did not show changes in chemical groups nor thermal properties. However, the simulant-packaging-processing interaction resulted in changes in crystallinity, morphology, mechanical and barrier properties (water and oxygen), especially for metallized films in contact with acidic food simulants. The results indicate that although OH resulted in changes in packaging materials, these materials can be used under the conditions applied in this study., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

We describe a natural coinfection with canine distemper virus (CDV) and yellow fever virus in a free-ranging neotropical primate of the genus Callithrix , found dead in the northeastern region of Brazil. The laboratory diagnosis included histopathology, immunohistochemistry, rRT-PCR, and phylogenetic analyses. The CDV sequences from this primate in Brazil represent a divergent lineage in Rio Grande do Norte, closely related to genotypes EU1/South America 1 and South America 2. To our knowledge, this is the first report of natural coinfection by CDV and yellow fever virus in a neotropical primate, underscoring the need to further investigate the circulation of this virus in Brazilian nonhuman primates and its potential implications for wildlife conservation.

Inherited retinal dystrophies/degenerations (IRDs) are the leading cause of visual impairment and incurable familial blindness in the Western world. Given the clinical and genetic heterogeneity, establishing a molecular diagnosis is especially relevant. The aim of this study was to perform the first nationwide survey to understand the prevalence and current management of IRDs in Portugal. A response was obtained from 26 healthcare providers (HCP) (76.5% response rate). Only 4 respondents reported not managing IRD patients. Most HCPs (68.1%) reported managing up to 100 patients, while three currently manage between 501 and 1000 patients. Based on the Portuguese population, an estimated IRD prevalence of 0.031%, i.e., about 1 in 3000 individuals, was calculated. In most HCPs (86.3%), most patients are adults, and non-syndromic retinitis pigmentosa is the most frequent diagnosis. Only 4 HCPs currently use the national, web-based IRD registry (IRD-PT). However, all but one respondent expressed interest in participating in such a registry. Genetic testing is available in 54.5%, with 58.3% HCPs reporting solved rates between 61-80%, but 4 to 9 months to get a genetic test result in 83.4% of cases. Based on this survey, the prevalence of biallelic RPE65-associated disease in Portugal is 0.00031%, i.e., approximately 1:300,000 individuals. Data from this study provide vital background information on national differences in the diagnosis and management of IRD patients. Nationwide implementation of the IRD-PT registry should be encouraged and supported to provide population-based reference data and to identify patients eligible for current and future therapies., (© 2024. The Author(s).)

The issue of withrawing and withholding life-sustaining interventions is an important source of controversy among healthcare professionals caring for patients with serious illnesses. Misguided decisions, both in terms of the introduction/maintenance and the withdrawal/withholding of these measures, represent a source of avoidable suffering for patients, their loved ones, and healthcare professionals. This document represents the position statement of the Bioethics Committee of the Brazilian Palliative Care Academy on this issue and establishes seven principles to guide, from a bioethical perspective, the approach to situations related to this topic in the context of palliative care in Brazil. The position statement establishes the equivalence between the withdrawal and withholding of life-sustaining interventions and the inadequacy related to initiating or maintaining such measures in contexts where they are in disagreement with the values and care goals defined together with patients and their families. Additionally, the position statement distinguishes strictly futile treatments from potentially inappropriate treatments and elucidates their critical implications for the appropriateness of the medical decision-making process in this context. Finally, we address the issue of conscientious objection and its limits, determine that the ethical commitment to the relief of suffering should not be influenced by the decision to employ or not employ life-sustaining interventions and warn against the use of language that causes patients/families to believe that only one of the available options related to the use or nonuse of these interventions will enable the relief of suffering.

Background: People with Parkinson's Disease (PwPD) have motor symptoms that directly interfere on dry land walking performance. Despite the shallow water walking is a viable and beneficial physical intervention for PwPD, it lacks information on the comparison of the biomechanical responses of the shallow water walking by PwPD and age paired healthy individuals., Research Question: Are there differences in the spatiotemporal and angular responses of shallow water walking by older adults with and without Parkinson's disease?, Methods: In this cross-sectional study, ten older adults (9 men/1 women) with Parkinson disease (PwPD group) and ten older adults (3 men/7 women) without Parkinson's disease (Older group) walked in shallow water at self-selected comfortable speed on pool floor in the immersion depths of waist and xiphoid levels. The 2D kinematic data from the sagittal plane was collected to calculate the walking speed, stride length, stride frequency, duty factor, walk ratio, lower limb joints' range of motion and peak angular speed RESULTS: Both groups reduced similarly the walking speed with the immersion depth increase. The speed decrease was achieved by a reducing both the stride frequency and stride length only in the PwPD. The PwPD had lower contact phase than Older in the waist depth, probably due to the reduced risk of fall in water immersion and to attenuate drag force effects. The total range of joint motion was similar between groups, while the peak angular speed of ankle and knee reduced in the deeper depth in both groups., Significance: The present findings can help professionals of aquatic rehabilitation to choose the best depth for exercise programs, according to the treatment objectives. To our knowledge, this was the first study that analyzed spatiotemporal and angular variables during shallow water walking of PwPD at different depths and compared them with older people without Parkinson's disease., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Our study identified strains of the A/H5N1 virus in analyzed samples of subsistence poultry, wild birds, and mammals, belonging to clade 2.3.4.4b, genotype B3.2, with very high genetic similarity to strains from Chile, Uruguay, and Argentina. This suggests a migratory route for wild birds across the Pacific, explaining the phylogenetic relatedness. The Brazilian samples displayed similarity to strains that had already been previously detected in South America. Phylogeographic analysis suggests transmission of US viruses from Europe and Asia, co-circulating with other lineages in the American continent. As mutations can influence virulence and host specificity, genomic surveillance is essential to detect those changes, especially in critical regions, such as hot spots in the HA, NA, and PB2 sequences. Mutations in the PB2 gene (D701N and Q591K) associated with adaptation and transmission in mammals were detected suggesting a potential zoonotic risk. Nonetheless, resistance to neuraminidase inhibitors (NAIs) was not identified, however, continued surveillance is crucial to detect potential resistance. Our study also mapped the spread of the virus in the Southern hemisphere, identifying possible entry routes and highlighting the importance of surveillance to prevent outbreaks and protect both human and animal populations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The transplacental transmission of parasites and hemoparasites is crucial for understanding the epidemiology of diseases. This study aimed to assess the prevalence of hemopathogens in bovine fetuses at various gestational periods. Samples were obtained from a slaughterhouse in the state of Minas Gerais, Brazil, and a total of 236 fetuses were collected. DNA extracted from blood samples (145) and organ samples (a pool of brain and spleen) (236) underwent a nested PCR (nPCR) assay to detect Babesia spp., Theileria spp., Trypanosoma vivax, Anaplasma marginale, Anaplasma bovis, Anaplasma phagocytophilum, Ehrlichia minasensis, and hemotropic Mycoplasma spp. Additionally, serological analysis of 145 plasma samples was conducted using the indirect fluorescent antibody test-IFAT to detect IgG against Babesia bovis, Babesia bigemina, A. marginale, and Trypanosoma vivax. The observed prevalence of transplacental transmission was 19.3 %, 6.2 %, 42.7 % and 2.7 %, for A. marginale, B. bigemina, 'Candidatus M. haemobos', and Mycoplasma wenyonii, respectively. The prevalence of A. marginale by gestational trimester was 16 % (13/81) in the second trimester and 23 % (14/60) in the third trimester, with no positive samples in the first trimester. Regarding the species B. bovis and B. bigemina, all evaluated animals tested negative by nPCR, and no serological evidence for B. bovis was found by the IFAT. Babesia bigemina demonstrated an overall seroprevalence of 6.2 % (9/145), with 4.8 % (7/145) in the last trimester and 1.3 % (2/145) in the second trimester of pregnancy. In total, 42.7 % (62/145) of blood samples were positive for 'Candidatus M. haemobos', with 42 % (34/81) in the middle trimester, and 43 % (26/60) in the final trimester of pregnancy. Mycoplasma wenyonni was detected in 2.7 % (4/145) blood samples, all in coinfection with 'C. M. haemobos'. The prevalence by pregnancy trimester was 25 % (1/4) in the first trimester; 1.2 % (1/81) in the second trimester and 3.3 % (2/60) in the third trimester of pregnancy. Hemopathogen DNA was detected in fetus blood samples but not the brain or spleen samples. All the samples were negative for T. vivax, Theileria spp., Anaplasma spp. and Ehrlichia spp. Overall, in this study, approximately 70 % of fetuses were positive for one or more of the studied parasites. No significant associations were observed between pairs of pathogens, except 'C. M. haemobos' and A. marginale., (Copyright © 2024. Published by Elsevier GmbH.)

Objectives: Muscle loss is one of the phenotypic criteria of malnutrition, is highly prevalent in patients with cirrhosis, and is associated with adverse outcomes. Mid-arm muscle circumference (MAMC) estimates the skeletal muscle mass and is especially helpful in cases of fluid overload. This study aimed to propose MAMC cutoff points for patients with cirrhosis and demonstrate its association with 1-year mortality., Methods: This is an analysis of cohort databases from five reference centers in Brazil that included inpatients and outpatients with cirrhosis aged ≥18 y. The nutritional variables obtained were the MAMC (n = 1075) and the subjective global assessment (n = 629). We established the MAMC cutoff points stratified by sex based on the subjective global assessment as a reference standard for malnutrition diagnosis, considering the sensitivity, specificity, and Youden index. An adjusted Cox regression model was used to test the association of MAMC cutoff points and 1-year mortality., Results: We included 1075 patients with cirrhosis, with a mean age of 54.8 ± 11.3 y; 70.4% (n = 757) male. Most patients had alcoholic cirrhosis (47.1%, n = 506) and were classified as Child-Pugh B (44.7%, n = 480). The MAMC cutoff points for moderate and severe depletion were ≤21.5 cm and ≤24.2 cm; ≤20.9 cm and ≤22.9 cm for women and men, respectively. According to these cutoff points, 13.8% (n = 148) and 35.1% (n = 377) of the patients had moderate or severe MAMC depletion, respectively. The 1-year mortality rate was 17.3% (n = 186). In the multivariate analysis adjusted for sex, age, MELD-Na, and Child-Pugh scores, a severe depletion in MAMC was an independent increased risk factor for 1-year mortality (HR: 1.71, 95% CI: 1.24-2.35, P < 0.001). Each increase of 1 cm in MAMC values was associated with an 11% reduction in 1-year mortality risk (HR: 0.89, 95% CI: 0.85-0.94, P < 0.001)., Conclusions: Low MAMC classified according to the new cutoff points predicts mortality risk in patients with cirrhosis and could be used in clinical practice., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Human reproduction goes through many challenges to its success and in many cases it fails. Cases of pregnancy loss are common outcomes for pregnancies, and implantation failures (IF) are common in assisted reproduction attempts. Although several risk factors have already been linked to adverse outcomes in reproduction, many cases remain without a definitive cause. Genetics of female reproduction is a field that may bring some pieces of this puzzle; however, there are no well-defined genes that might be related to the risk for recurrent pregnancy loss (RPL) and IF. Here, we present a literature review of the studies of genetic association in RPL and IF carried out in the Brazilian population and complemented with a database search to explore genes previously related to RPL and IF, where a search for genes previously involved in these conditions was performed in OMIM, HuGE, and CTD databases. Finally, we present the next steps for reproductive genetics investigation, through genomic sequencing analyses and discuss future plans in the study of RPL genetics. The combined strategy of looking for literature and databases is useful to raise hypotheses and to identify underexplored genes related to RPL and IF.

Rationale: Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) characterized by continuous inflammation of the colonic mucosa. Autoimmune hepatitis (AIH) is a chronic liver disease characterized by hypergammaglobulinemia, circulating autoantibodies, interface hepatitis, and favorable response to immunosuppression. An association between IBD and AIH is uncommon, and experts have suggested that in patients with overlapping IBD and AIH, the anti-tumor necrosis factor agents can be used. Therefore, this study reports a rare case of a patient with liver cirrhosis due to AIH and UC refractory to conventional treatment and discusses the risks and benefits of using anti-tumor necrosis factor in both conditions., Patient Concerns: A 28-year-old female presented with symptoms of diarrhea, abdominal pain, asthenia, and inappetence, accompanied by abdominal collateral circulation, anemia, alteration of liver enzymes, and elevation of C-reactive protein levels., Diagnoses: The patient underwent a liver biopsy, which was consistent with liver cirrhosis due to AIH. Colonoscopy showed an inflammatory process throughout the colon, compatible with moderately active UC., Interventions: The patient received mesalazine, azathioprine, and corticotherapy, with no control of the inflammatory process. Faced with refractoriness to drug treatment and side effects of corticosteroids with an increased risk of severe infection due to cirrhosis, we opted to use infliximab for the treatment of UC. The patient presented with a clinical response and infliximab therapy was maintained., Outcomes: Eight months after starting infliximab therapy, the patient developed pneumonia with complications from disseminated intravascular coagulation and died., Lessons Subsections: AIH is a rare cause of elevated transaminase levels in patients with UC. The best treatment to control the 2 conditions should be evaluated with vigilance for the side effects of medications, mainly infections, especially in patients with cirrhosis., Competing Interests: The authors have no funding and conflicts of interests to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

This study evaluated bond strength of glass fiber posts to root dentin using push-out (PO) and diametral compression (DC), testing glycolic acid as a conditioner and varying dentin moisture. An additional aim was to test whether DC can be an alternative test to PO for bond strength assessment. Eighty bovine teeth were divided into eight groups (n = 10) defined by the use of either 37% glycolic acid or 37% phosphoric acid (PA) on moist or wet dentin before bonding with either Adapter SingleBond/RelyX ARC or One Step Plus/Duo-Link Bisco. Each tooth provided discs with an internal diameter of 2 mm, external diameter of 5 mm, and height of 2 mm, which underwent PO and DC. Finite element analysis (FEA) was carried out on 3D models. When analyzing PO results through linear regression, the highest values of bond strength were observed using glycolic acid on wet dentin in the cervical and middle thirds of the teeth. Analyzing DC results, the only statistical influence on values was the dental thirds. The scatterplot of the DC results and the PO bond strength values indicated no relationship between the results of the two tests (r = 0.03; p = 0.64). PO test detected more sensitive changes in bond strength values than DC., (© 2024 Scandinavian Division of the International Association for Dental Research. Published by John Wiley & Sons Ltd.)

Objectives: Peptic ulcer is the most common source of non-variceal bleeding. However, it remains controversial whether the outcomes of cirrhotic patients with peptic ulcer bleeding differ from those with variceal bleeding., Methods: Cirrhotic patients with acute gastrointestinal bleeding (AGIB) who underwent endoscopy and had an identifiable source of bleeding were retrospectively screened from an international multicenter cohort. Logistic regression analyses were performed to explore the impact of peptic ulcer bleeding on in-hospital death and 5-day failure to control bleeding. Propensity score matching (PSM) analysis was performed by matching age, gender, Child-Pugh score, and model for end-stage liver disease score between the peptic ulcer bleeding and variceal bleeding groups., Results: Overall, 1535 patients were included, of whom 73 (4.7%) had peptic ulcer bleeding. Multivariate logistic regression analyses showed that peptic ulcer bleeding was not independently associated with in-hospital death (OR = 2.169, p  = 0.126) or 5-day failure to control bleeding (OR = 1.230, p  = 0.680). PSM analyses demonstrated that both in-hospital mortality (9.7% vs. 6.3%, p  = 0.376) and rate of 5-day failure to control bleeding (6.9% vs. 5.4%, p  = 0.787) were not significantly different between the two groups., Conclusions: The impact of peptic ulcer bleeding on the in-hospital outcomes of cirrhotic patients is similar to that of variceal bleeding.

Introduction: Human Erythrovirus (parvovirus) B19 infection can produce symptoms similar to those produced by Dengue, Chikungunya, and Zika viruses, making clinical diagnosis difficult. The importance of erythrovirus B19 in human pathology has been increased and reported in numerous studies published globally., Methods: The B19V infection was investigated by real-time PCR in sera samples from patients with signs and symptoms related to classic arboviral symptoms. This study was conducted to provide information on the genetic diversity of Human Erythrovirus B19 (B19V) circulating in the state of Mato Grosso do Sul, Midwest region of Brazil, from 2017 to 2022. A total of 773 sera samples of patients with negative diagnostic results for Dengue, Chikungunya, and Zika, during the study period were analyzed., Results: Erythrovirus DNA was found in 10.6% (82/773) of patients, among them 10 were pregnant women. Four samples were completely sequenced, and the other five partially, to genotype by phylogenetic reconstruction. All samples belong to worldwide dispersed genotype 1, subgenotype 1a., Discussion: The findings of the study demonstrate the importance of including B19V in differential laboratory diagnosis for epidemiological purposes and appropriate patient management. The diagnosis for B19V should be performed, particularly among pregnant women, immunocompromised patients, and individuals with hemolytic diseases, given that the infection is more severe in these cases., 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 Lichs, Fernandez, Nascimento, Alcantara, Lemos, Carvalho, Demarchi, Gonçalves, Naveca and Favacho.)

The cocoa tree ( Theobroma cacao L.) has seeds that after processing become a valuable agricultural commodity in the world. In Brazil, the state of Pará located in the Eastern Amazon is the main producer, accounting for more than 53% of the national production. Although the region is the largest producer, no studies are found in the literature containing data on the sensory quality of the beans. Thus, the purpose of this study is to establish the sensory profile of Amazonian cocoa from the main cocoa-producing regions of the Eastern Amazon (Lower Tocantins River, Northeast, West, Southeast and Trans-Amazon). The sensory profile was established from the Quantitative Descriptive Analysis (QDA), in addition to using an affective test to verify consumer preference for the chocolates produced. Physical, physicochemical and bioactive compound evaluations were carried out. Beans from different regions had a similar sensory profile; however, it was possible to observe some differences in certain descriptor terms. In the physical evaluation, the samples presented an acceptable commercial standard, and the humidity was within the values established by the legislation. It was found that the post-harvest and/or processing parameters had no influence on the quality attributes of cocoa beans.

Microwave-assisted extraction of mucilage from juá was investigated using response surface methodology. The optimal conditions for extraction were a power of 300 W, an extraction time of 240 s, a pH of 8.0, and a water/sample ratio of 1/6, which achieved a 26.43% yield. The monosaccharide composition and antioxidant activity of the mucilage from juá fruits from different regions of Caatinga were investigated. The fruits from Agreste Paraibano showed the highest mucilage extraction yield (18.64%) compared to that of fruits from Mata Paraibana (MP) (12.37%), Borborema (BB) (11.47%), and Sertão Paraibano (8.31%) (p < 0.05). Glucose (32.8%-50.8%) and arabinose (19.3%-32.9%) were the main monosaccharides found in juá mucilage. The mucilage from fruits in the MP presented the highest antioxidant activity in the 2,2-diphenyl-1-picrylhydrazyl and oxygen radical absorbance capacity assays. Our results demonstrated the potential for the future exploration and application of juá mucilage in the food industry. PRACTICAL APPLICATION: Juá (Ziziphus joazeiro Mart.) mucilage contains phenolic compounds and antioxidant activity, and its extraction by MAE is efficient, as it contributed to a higher yield., (© 2024 Institute of Food Technologists.)

Objective: This study evaluated the antimicrobial effect and cytotoxicity of hypochlorous acid(HClO) obtained from an innovative electrolytic device., Design: The root canals of fifty extracted human teeth were inoculated with Enterococcus faecalis and divided into 5 groups (n = 10): DW (control); 2% chlorhexidine gel(CHX); 2.5% sodium hypochlorite(NaOCl); 250 ppm HClO and 500 ppm HClO. The counting of colony forming units evaluated the decontamination potential of each group. Cytotoxicity was evaluated after inoculation of tested protocols in fibroblastic cells for 3 min, calculating the cell viability. Specific statistical analysis was performed (α = 5%)., Results: The highest bacterial reduction was observed in experimental groups, with no statistical differences from each other (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences from each other (p < 0.05)., Conclusions: It could be concluded that HClO presented high antimicrobial activity and low cytotoxicity at both tested concentrations., Competing Interests: Declaration of Competing Interest Dr. Liviu Steier owns IP rights on the Dentaqua device. The rest of authors state that they have no financial affiliation (e.g., employment, direct payment, stock holdings, retainers, consultantships, patent licensing arrangements or honoraria) or involvement with any commercial organization with direct financial interest in the subject or materials discussed in this manuscript, nor have any such arrangements existed in the past three years., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Currently, the Enterobacteriaceae species are responsible for a variety of serious infections and are already considered a global public health problem, especially in underdeveloped countries, where surveillance and monitoring programs are still scarce and limited. Analyses were performed on the complete genome of an extensively antibiotic-resistant strain of Enterobater hormaechei , which was isolated from a patient with non-Hodgkin's lymphoma, who had been admitted to a hospital in the city of Manaus, Brazil., Methods: Phenotypical identification and susceptibility tests were performed in automated equipment. Total DNA extraction was performed using the PureLink genomic DNA mini-Kit. The genomic DNA library was prepared with Illumina Microbial Amplicon Prep and sequenced in the MiSeq Illumina Platform. The assembly of the whole-genome and individual analyses of specific resistance genes extracted were carried out using online tools and the Geneious Prime software., Results: The analyses identified an extensively resistant ST90 clone of E. hormaechei carrying different genes, including bla CTX-M-15 , bla GES-2 , bla TEM-1A , bla ACT-15 , bla OXA-1 and bla NDM-1 , [ aac(3)-IIa, aac(6')-Ian, ant(2″)-Ia ], [ aac(6')-Ib-cr , (qnrB1)], dfrA25 , sul1 and sul2 , catB3 , fosA , and qnr B, in addition to resistance to chlorhexidine, which is widely used in patient antisepsis., Conclusions: These findings highlight the need for actions to control and monitor these pathogens in the hospital environment.

Objective: To learn the strategies used regarding underreporting of pesticide use in rural areas., Methods: A qualitative study was carried out in eight primary healthcare units in rural areas and two emergency care units in a municipality in southern Brazil. Data collection took place in 2023 through interviews. Twenty professional nurses participated. The data was submitted to content analysis., Results: The strategies identified were lifelong and continuing education for the professionals who carry out the notification, active search and training of workers who deal directly with this type of substance, computerizing the notification by filling in the forms online, and carrying out research on the subject., Final Considerations: Nurses play an important role in reporting occupational accidents caused by the use of pesticides, improving occupational safety in rural areas.

SARS-CoV-2 virus emerged as a new threat to humans and spread around the world, leaving a large death toll. As of January 2023, Brazil is among the countries with the highest number of registered deaths. Nonpharmacological and pharmacological interventions have been heterogeneously implemented in the country, which, associated with large socioeconomic differences between the country regions, has led to distinct virus spread dynamics. Here, we investigate the spatiotemporal dispersion of SARS-CoV-2 lineages in the Pernambuco state (Northeast Brazil) throughout the distinct epidemiological scenarios that unfolded in the first 2 years of the pandemic. We generated a total of 1,389 new SARS-CoV-2 genomes from June 2020 to August 2021. This sampling captured the arrival, communitary transmission, and the circulation of the B1.1, B.1.1.28, and B.1.1.33 lineages; the emergence of the former variant of interest P.2; and the emergence and fast replacement of all previous variants by the more transmissible variant of concern P.1 (Gamma). Based on the incidence and lineage spread pattern, we observed an East-to-West to inner state pattern of transmission, which is in agreement with the transmission of more populous metropolitan areas to medium- and small-size country-side cities in the state. Such transmission patterns may be partially explained by the main routes of traffic across municipalities in the state. Our results highlight that the fine-grained intrastate analysis of lineages and incidence spread can provide actionable insights for planning future nonpharmacological intervention for air-borne transmissible human pathogens.IMPORTANCEDuring the COVID-19 pandemic, Brazil was one of the most affected countries, mainly due its continental-size, socioeconomic differences among regions, and heterogeneous implementation of intervention methods. In order to investigate SARS-CoV-2 dynamics in the state of Pernambuco, we conducted a spatiotemporal dispersion study, covering the period from June 2020 to August 2021, to comprehend the dynamics of viral transmission during the first 2 years of the pandemic. Throughout this study, we were able to track three significant epidemiological waves of transmission caused by B1.1, B.1.1.28, B.1.1.33, P.2, and P.1 lineages. These analyses provided valuable insights into the evolution of the epidemiological landscape, contributing to a deeper understanding of the dynamics of virus transmission during the early years of the pandemic in the state of Pernambuco., Competing Interests: The authors declare no conflict of interest.

Aristolochia plants are emblematic from an ethnopharmacological viewpoint and are know to possess numerous biological properties, including antiseptic. However, the medicinal potential of these species is debatable because of their representative chemical constituents, aristolochic acids (AAs) and aristolactams (ALs), which are associated, for instance, with nephropathy and cancer. These contrasting issues have stimulated the development of approaches intended to detoxification of aristoloquiaceous biomasses, among which is included the bioconversion method using larvae of the specialist phytophagous insect Battus polydamas, previously shown to be viable for chemical diversification and to reduce toxicity. Thus, eleven Aristolochia spp. were bioconverted, and the antimicrobial activities of the plant methanolic extracts and its respective bioconversion products were evaluated. The best results were found for Aristolochia esperanzae, Aristolochia gibertii, and Aristolochia ringens against Bacillus cereus, with MIC ranging from 7.8 to 31.25 μg/mL. These three species were selected for chemical, antioxidant, cytotoxic, hemolytic, and mutagenic analyses. Chemical analysis revealed 65 compounds, 21 of them possible bioconversion products. The extracts showed potential to inhibit the formation and degradation of B. cereus biofilms. Extracts of A. gibertii and its bioconverted biomass showed antioxidant activity comparable to dibutylhydroxytoluene (BHT) standard. Bioconversion decreased the hemolytic activity of A. esperanzae and the cytotoxicities of A. esperanzae and A. gibertii. None of the extracts was found to be mutagenic. The bioactivities of the fecal extracts were maintained, and biocompatibility was improved. Therefore, the results obtained in this study reveal positive expectations about the natural detoxification process of the Aristolochia species., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2023. Published by Elsevier B.V.)

Fungicides are often used prophylactically, to control fungal diseases. Although fungicides have been designed to control pests/fungi, they frequently share molecular targets with non-target species, including humans. Tebuconazole, a fungicide belonging to the class of triazoles, is widely employed, has moderate to high persistence in soil, and can be found in different environmental levels. This fungicide is metabolized to the main hydroxy-derived metabolite, Tebuconazole-tert-butyl-hydroxy (or hydroxytebuconazole). This study aims to unveil the action mechanism of Tebuconazole and the role played by its metabolite, Tebuconazole-tert-butyl-hydroxy (5-(4-Chlorophenyl)-2,2-dimethyl-3-(1H-1,2,4-triazol-1-ylmethyl)-1,3-pentanediol), within the expected spectrum of toxicity. In silico and in vitro analyses (MTT assay, cell cycle evaluation, annexin/PI assay, ROS accumulation assay, and mitochondrial membrane potential determination) were performed in HepG2 cells for 24 h and 48 h. Although in silico analysis suggested that both Tebuconazole and Tebuconazole-tert-butyl-hydroxy are potentially hepatotoxic, only Tebuconazole affected the tested cell line. Reduced MTT metabolism, and decreased mitochondrial membrane potential were the main findings. In conclusion, the action mechanism of Tebuconazole may be related to mitochondrial dysfunction. However, the findings of this study pointed out that Tebuconazole-tert-butyl-hydroxy does not play an important role in Tebuconazol toxicity. The study has generated new data that will help to understand how fungicides behave in the environment., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Purpose: In the natural environment, humans must continuously negotiate irregular and unpredictable terrain. Recently, the poles have been extensively used during trial running events. However, we know little about how humans adjust posture and bilateral coordination to use poles in irregular terrain. Here, we compared kinematics, bilateral coordination and perceptual responses between regular (compact dust) and irregular terrain (medium-length grass) during running at preferred speed with and without poles., Methods: In this transversal observational study, thirteen young healthy adults (8 men; mean ± SD; age 29.1 ± 8.0 years, body mass 76.8 ± 11.4 kg; height 1.75 ± 0.08 m) were evaluated during running at a self-selected comfortable speed with and without poles on regular and irregular terrains., Results: Our results show that, despite more flexed pattern on lower-limb joints at irregular terrain, the usage of poles was not enough to re-stabilize the bilateral coordination. Also, the perceived exertion was impaired adding poles to running, probably due to more complex movement pattern using poles in comparison to free running, and the invariance in the bilateral coordination., Conclusion: Besides the invariability of usage poles on bilateral coordination and lower-limb kinematics, the runners seem to prioritize postural stability over lower limb stiffness when running in medium-length grass given the larger range of ankle and knee motion observed in irregular terrain. Further investigations at rougher/hilly terrains will likely provide additional insights into the neuromotor control strategies used to maintain the stability and on perceptual responses using poles during running., (© 2024. The Author(s).)

Aging involves physical and cognitive deterioration in older adults. Detecting predictors of dementia early is crucial to identify its onset. This study aimed to associate physical and psychological determinants with cognitive performance in older adults. Observational study with 221 older adults, classified according to cognitive impairment. We evaluated cognitive function by Mini-Mental State Examination. Physical determinants encompassed muscle strength, functional mobility, and cardiorespiratory fitness, while psychological consisted of quality of life and activities of daily living. Multiple linear regression was performed to investigate this relationship. Physical and psychological determinants were significantly linked to cognitive impairment, including lower muscle strength, reduced functional mobility and of cardiorespiratory fitness. The influence of environment, autonomy, and engagement in daily activities on cognitive impairment was also observed. The analysis of physical and psychological determinants could help to aid in distinguishing individuals with cognitive impairment., (© 2024. The Author(s).)

Objectives: We report the first case of Oropouche fever detected in the border region of Colombia., Methods: Using a multiplex real-time polymerase chain reaction (PCR), genetic sequencing and clinical characteristics during the dengue epidemic in 2019, a total of 175 samples were analysed, from cases notified to the system epidemiological surveillance such as dengue., Findings: The Oropouche virus (OROV) isolate from Leticia belongs to lineage 2 according to both M and S genome segments maximum likelihood (ML) analysis, shares a common ancestor with samples obtained in Esmeraldas, Ecuador and Turbaco, Colombia. The patient: a woman resident in the border neighbourhood of the municipality of Leticia had the following symptoms: fever, headache, retro-orbital pain and myalgias., Main Conclusion: This cross-border surveillance can be useful to give an alert about the entry or exit of arboviruses circulation in the region, which are often underreported in public health surveillance systems.

Background: Dengue virus (DENV) causes an important disease and directly affects public health, being the arbovirus that presents the highest number of infections and deaths in the Western Brazilian Amazon. This virus is divided into 4 serotypes that have already circulated in the region., Methodology: Molecular characterization of a cohort containing 841 samples collected from febrile patients between 2021 and 2023 was analyzed using a commercial kit to detect the main arboviruses circulating in Brazil: Zika, DENV-1, DENV-2, DENV-3, DENV-4 and, Chikungunya. Subsequently, Sanger sequencing was performed for positive samples., Results: The cohort detected 162 positive samples, 12 for DENV-1 and 150 identified as DENV-2, indicating co-circulation of serotypes. The samples were subjected to sequencing and the analysis of the sequences that obtained good quality revealed that 5 samples belonged to the V genotype of DENV-1 and 46 were characterized as DENV-2 Cosmopolitan genotype-lineage 5., Conclusion: The results allowed us to identify for the first time the Cosmopolitan genotype in Rondônia, Brazilian Western Amazon, and its fast spread dispersion., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Underwater long-endurance platforms are crucial for continuous oceanic observation, allowing for sustained data collection from a multitude of sensors deployed across diverse underwater environments. They extend mission durations, reduce maintenance needs, and significantly improve the efficiency and cost-effectiveness of oceanographic research endeavors. This paper investigates the closed-loop depth control of actuation systems employed in underwater vehicles, focusing on the energy consumption of two different mechanisms: variable buoyancy and propeller actuated devices. Using a prototype previously developed by the authors, this paper presents a detailed model of the vehicle using both actuation solutions. The proposed model, although being a linear-based one, accounts for several nonlinearities that are present such as saturations, sensor quantization, and the actuator brake model. Also, it allows a simple estimation of the energy consumption of both actuation solutions. Based on the developed models, this study then explores the intricate interplay between energy consumption and control accuracy. To this end, several PID-based controllers are developed and tested in simulation. These controllers are used to evaluate the dynamic response and power requirements of variable buoyancy systems and propeller actuated devices under various operational conditions. Our findings contribute to the optimization of closed-loop depth control strategies, offering insights into the trade-offs between energy efficiency and system effectiveness in diverse underwater applications.

Rationale and Objectives: Hepatocellular carcinoma (HCC) treatment often requires transarterial chemoembolization (TACE). However, TACE efficacy is controversial in the presence of portal vein thrombosis (PVT). Although transarterial radioembolization (TARE) benefit was previously documented in PVT, neither the objective tumor response (OTR) after TARE with Iodine-131-lipiodol ( 131 I-lipiodol) nor the PVT effect on the results of locoregional therapies was accurately measured in prospective clinical trials. The aim of this study was to compare OTR and survival obtained by TARE with 131 I-lipiodol versus TACE in patients with cirrhosis and HCC, as well as between those with and without PVT., Materials and Methods: 33 patients were included, from whom 38 tumors were assessed. OTR was quantified by a special algorithm to measure hypervascular HCC tissue., Results: 19 tumors received each therapy. Nine subjects (27%) had PVT, most of them in the TARE group (p = 0.026). Mean OTR according to the tumor volumes was 24.2% ± 56% after TARE and 32.8% ± 48.9% after TACE, with no difference between the treatments (p = 0.616). Similar values were also observed between those with and without PVT (p = 0.704). Mean survival was 340 days and did not differ between the two treatments (p = 0.596), but was 194 days in PVT cases (p = 0.007)., Conclusions: This is the first study in which OTR obtained by TARE with 131 I-lipiodol is accurately measured. Additionally, PVT impact on survival after TARE and TACE was precisely documented. Although the TARE group had more PVT subjects (who had shorter survival), TARE and TACE achieved similar OTR and OS rates., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Fernando Gomes Romeiro reports financial support was provided by São Paulo Research Foundation (FAPESP). Fernando Gomes Romeiro reports financial support was provided by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Thermo-mechanical pulping produces well-individualized fibers compared to wood particles and less fragile fibers compared to Kraft pulping, besides presenting higher volume, higher yield, and lower production cost, which can be an exciting alternative for the fiber-cement industries. This study evaluated the impact of soak and dry-aging cycles on the performance of extruded composites reinforced with non-bleached eucalyptus fibers. The cement matrix comprised cement (70%) and limestone (30%). Composites were reinforced with 1 to 5% of eucalyptus fiber by cement mass and tested on the 28th day of cure at 99% relative humidity and after 400 accelerated aging cycles. The water absorption and apparent porosity gradually increased with the reinforcement level. Composites with 4 and 5% fibers showed the highest toughness (0.21 and 0.23 kJ/m 2 , respectively). The aging by 400 soak-dry cycles reduced the composites' water absorption and apparent porosity. The modulus of elasticity (MOE), rupture (MOR), and toughness increased, except for toughness for composites reinforced with 1 and 5% fibers, explained by the cementitious matrix's continuous hydration, fiber mineralization, and natural carbonation. In general, eucalyptus thermo-mechanical fibers were suitable for producing cementitious composites. Cementitious composites with 3% fibers presented a higher MOR, MOE, low water absorption, and apparent porosity after 400 accelerated aging cycles. In addition, the composites with 4% fibers also presented remarkable improvements in these properties. The aging cycles did not result in composites with less resistance, a positive fact for their application as tiles and materials for external use in civil construction., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: This study aimed to compare the antimicrobial action, cytotoxicity, cleaning ability, and erosion of dentine of hypochlorous acid (HClO) obtained from an electrolytic device at two different concentrations (Dentaqua) and three concentrations of sodium hypochlorite (NaOCl)., Methods: Microbiological test-The root canals of sixty single-rooted extracted human teeth were inoculated with Enterococcus faecalis and divided into 6 groups (n = 10), according to decontamination protocol: DW (control); 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl; 250 ppm HClO and 500 ppm HClO. The colony-forming units were counted to evaluate the decontamination potential of each group, calculating the reduction in bacterial percentage. Cytotoxicity test-Cytotoxicity was evaluated after inoculation of the same tested protocols in fibroblastic cells for 3 min, calculating the cell viability percentages. Specifical statistical analysis was performed (α = 5%). Cleaning ability and erosion-Fifty-six single-rooted bovine lower incisors were divided into seven groups of 8 roots each, being the test groups 1% NaOCl; 2.5% NaOCl; 5,25% NaOCl; 250 ppm HClO and 500 ppm HClO, and a negative and positive control. Negative control was not contaminated, and the other groups were inoculated with Enterococcus faecalis. SEM images were ranked as from the cleanest to the least clean. Erosion was also assessed, being ranked from the least to the most eroded dentine., Results: The highest bacterial reduction was observed in experimental groups, with no statistical differences between them (p > 0.05). The highest number of viable cells was observed in control group, followed by 250 ppm HClO and 500 ppm HClO groups, with statistical differences between them (p < 0.05). 1% NaOCl; 2.5% NaOCl; 5.25% NaOCl and 500 ppm HClO displayed the cleanest areas. All sodium hypochlorite groups displayed erosion with higher ranks with greater concentration, while hypochlorous acid did not display any erosion regardless the concentration., Conclusions: It is possible to conclude that HClO obtained from an electrolytic device presented high antimicrobial activity and low cytotoxicity in both tested concentrations. 500 ppm HClO did not display erosion and showed great cleaning ability., Clinical Relevance: The use of 500 ppm hypochlorous acid may reduce unfavorable behavior of sodium hypochlorite whilst maintaining its antimicrobial action., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)