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Purpose: Acute appendicitis (AA), classified as non-complicated acute appendicitis (NCAA) and complicated acute appendicitis (CAA), is the most common cause of abdominal pain in children requiring surgical treatment. If the first-line treatment for NCAA is to be debated between conservative management and surgery, authors find a consensus in choosing surgery as the first step for CAA in children. In the case of patients with CAA undergoing surgery, a broad-spectrum antibiotic therapy should be administered to reduce the risk of post-operative complications (POC). The rise in antibiotic resistance requires a review of recent data regarding bacterial species involved in AA. The primary aim of our study was to investigate the clinical effectiveness of different antibiotic protocols in patients undergoing surgery for CAA. The secondary aim was to verify the antibiotic’s in vitro effectiveness based on cultural examinations. Methods: A retrospective and prospective study was conducted on all patients operated on at our pediatric surgery department for CAA from January 2017 to January 2023. The following data were collected: age at surgery, sex, surgical technique, duration of the procedure, antibiotic therapy, duration of the hospital stay, cultural examination of peritoneal effusion, and POC. Results: We divided the patients enrolled (n = 182) into three groups of antibiotic protocols; only one group resulted in a statistically significant lower rate of POC. Different pathogens were isolated (Enterobacteriaceae, non-fermentative Gram-negative bacilli, anaerobes, Gram-positive cocci), and the in vitro rate of antimicrobial sensitivity varied from 40% to 94% in the three groups of patients. Conclusions: Based on cultural examinations, our study showed a high rate of inadequacy regarding the therapy with amoxicillin + clavulanic acid despite a low rate of complications. Radical surgery seems to be the best way to reduce complications in children with CAA.

Abstract Staphylococcus aureus is a relevant pathogen in bloodstream infections (BSI), and the emergency of the COVID-19 pandemic increased its antimicrobial resistance. S. aureus isolates from BSI (September/2019 - March/2021) were analyzed phenotypically and molecularly, in addition to the clinical features of the patients. Of 88 S. aureus isolates recovered from 85 patients, 25 were isolated before the pandemic and 63 during it, and 16 were from patients with COVID-19. A rate of 45.5% of methicillin-resistant isolates (MRSA) were found, and 5% of them were ceftaroline susceptible dose-dependent. Daptomycin non-susceptibility was observed in 9.1% of isolates. The USA800/ST5/SCCmecIV lineage was prevalent among MRSA isolates (41.8%). Besides, 30.2% of the isolates were associated with community-associated MRSA (CA-MRSA) genotypes. There was a significant impact on the resistance rates for cefoxitin, clindamycin and erythromycin among S. aureus isolates from BSI in COVID-19 patients and association with the previous use of azithromycin by them (p

Abstract Nepal, largely covered by the Himalayan mountains, hosts indigenous populations with distinct linguistic, cultural, and genetic characteristics. Among these populations, the Raute, Nepal’s last nomadic hunter-gatherers, offer a unique insight into the genetic and demographic history of Himalayan foragers. Despite strong cultural connections to other regional foragers, the genetic history of this population remains understudied. This study presents newly genotyped genome-wide SNP data of the Raute to explore their genetic isolation, their origins and potential as an older foraging lineage, and their genetic connections to other regional foragers. Our results show that high levels of inbreeding in the Raute indicate recent genetic isolation. Effective population size estimates suggest a dramatic population decline around 50 generations ago. Strong genetic similarity to Nepalese populations of various subsistence styles highlights a dynamic history of genetic interactions prior to isolation, with particular closeness to historical foragers like the Kusunda and Tharu, but excludes an ancient foraging lineage origin. The study underscores the complexity of human population dynamics in the Himalayas, suggesting a history of extensive interaction between foragers and farmers, followed by isolation and demographic decline among the Raute.

Abstract Background The rate of suicide attempts by patients with bipolar disorder is high. In addition to patient and country specific factors, environmental factors may contribute to suicidal behavior. Sunlight has multiple diverse impacts on human physiology and behavior. Solar insolation is defined as the electromagnetic energy from the sun striking a surface area on earth. We previously found that a large change in solar insolation between the minimum and maximum monthly values was associated with an increased risk of suicide attempts in patients with bipolar I disorder. Methods The association between solar insolation and a history of suicide attempts in bipolar disorder was again investigated using an international database with 15% more data and more sites at diverse locations and countries. Results Data were available from 5641 patients with bipolar I disorder living at a wide range of latitudes in 41 countries in both hemispheres. A large change in solar insolation between the minimum and maximum monthly values was associated with a history of suicide attempts in patients with bipolar I disorder, a replication of our prior analysis. The estimated model also associated state sponsored religion in the onset country, female gender, a history of alcohol or substance abuse, and being part of a younger birth cohort with a history of suicide attempts. Conclusions A large change between the minimum and maximum monthly values of solar insolation was associated with a history of suicide attempts in bipolar I disorder, replicating our prior research. Physicians should be aware that daylight has wide ranging physiological and psychiatric impacts, and that living with large changes in solar insolation may be associated with an increased suicide risk.

Abstract Background Effective communication with patients and their families is a fundamental skill for medical students to cultivate during their undergraduate training. However, communicating with pediatric patients presents unique challenges. This study investigated the perceptions, attitudes, and confidence levels of undergraduate medical students regarding communication skills in pediatrics. Methods A cross-sectional, quantitative, descriptive, and analytical survey was conducted by applying a validated questionnaire, the Housestaff Communication Survey (HCS), to medical students from two higher education institutions in Minas Gerais, Brazil. Data analysis was conducted using SPSS and Excel, employing descriptive statistical tests and multiple logistic regression analyses to evaluate communication, importance, and confidence. Results A total of 520 (52%) students participated in the study, with 422 (81.15%) aged from 20 to 29 years and 365 (68.27%) women. While only 113 (21.73%) students reported receiving training in communication skills with both adults and children during their undergraduate studies, over half (270) reported no such training. Those lacking training exhibited lower confidence levels compared with those trained exclusively with adults. Although most students recognized the importance of communication skills, their confidence levels were generally below 60%. Multiple logistic regression analysis identified gender, institution, academic period, and training as significantly associated variables with communication scores. Conclusions Training, gender, and academic period emerged as the most significant variables influencing communication skills. Most students expressed lower confidence in interviewing children. To enhance communication with pediatric patients and their families, comprehensive training in pediatric communication skills during undergraduate studies is imperative.

Abstract Objectives The objective of this study is to evaluate the diagnostic performance of perineal access cannulas tethered to a biplanar ultrasound probe in cognitive transperineal prostate biopsies of targets identified by multiparametric magnetic resonance imaging (mpMRI) by comparing the results of the PrecisionPoint (PP) Transperineal Access System with the double‐freehand (DFH) technique. Patients and methods All patients who underwent cognitive transperineal prostate biopsy of mpMRI targets using the PP or DFH technique between November 2020 and September 2023 were enrolled. All data related to mpMRI target biopsies were stratified by technique, visibility in transrectal ultrasound and analysed by comparing PP versus DFH. A standardised anaesthesia protocol with 1% mepivacaine was used in all biopsies. The tolerability of the procedures was assessed using a visual analogue scale (VAS). Results The number of mpMRI targets sampled was 166 in PP and 242 in DFH. In target biopsies, the PP system was associated with better diagnostic performance for clinically significant prostate cancer (Gleason score ≥3 + 4) compared to DFH for both ultrasound‐visible targets (61.4% vs. 48.0%) and non‐visible targets (41.4% vs. 14.9%) (p = 0.02). A higher rate of positive cores was obtained from targets sampled with PP (57.7% vs. 49.6%, p = 0.0002). The PP system was associated with the retrieval of significantly longer cores (p

Abstract An extension of the xFitter open-source program for QCD analyses is presented, allowing for a polynomial parameterization of the dependence of physical observables on theoretical parameters. This extension enables simultaneous determination of parton distribution functions (PDFs) and new physics parameters within the framework of the Standard Model Effective Field Theory (SMEFT). The functionalities of the code are illustrated in a sensitivity study, where a simultaneous determination of the PDFs, top quark mass and the couplings of selected dimension-6 SMEFT operators is addressed using projections for measurements of top quark-antiquark pair production at the High-Luminosity LHC. The importance of considering all the correlations of the parton distributions, top quark mass and the SMEFT parameters in a simultaneous QCD+SMEFT analysis is demonstrated. This work serves as a new platform for simultaneous extraction of the PDFs and the SM/SMEFT parameters based on xFitter.

Abstract Background Compatibility between plant parasites and their hosts is genetically determined {Citation}both interacting organisms. For example, plants may carry resistance (R) genes or deploy chemical defences. Aphid saliva contains many proteins that are secreted into host tissues. Subsets of these proteins are predicted to act as effectors, either subverting or triggering host immunity. However, associating particular effectors with virulence or avirulence outcomes presents challenges due to the combinatorial complexity. Here we use defined aphid and host genetics to test for co-segregation of expressed aphid transcripts and proteins with virulent or avirulent phenotypes. Results We compared virulent and avirulent pea aphid parental genotypes, and their bulk segregant F1 progeny on Medicago truncatula genotypes carrying or lacking the RAP1 (Resistance to Acyrthosiphon pisum 1) resistance quantitative trait locus. Differential gene expression analysis of whole body and head samples, in combination with proteomics of saliva and salivary glands, enabled us to pinpoint proteins associated with virulence or avirulence phenotypes. There was relatively little impact of host genotype, whereas large numbers of transcripts and proteins were differentially expressed between parental aphids, likely a reflection of their classification as divergent biotypes within the pea aphid species complex. Many fewer transcripts intersected with the equivalent differential expression patterns in the bulked F1 progeny, providing an effective filter for removing genomic background effects. Overall, there were more upregulated genes detected in the F1 avirulent dataset compared with the virulent one. Some genes were differentially expressed both in the transcriptome and in the proteome datasets, with aminopeptidase N proteins being the most frequent differentially expressed family. In addition, a substantial proportion (27%) of salivary proteins lack annotations, suggesting that many novel functions remain to be discovered. Conclusions Especially when combined with tightly controlled genetics of both insect and host plant, multi-omics approaches are powerful tools for revealing and filtering candidate lists down to plausible genes for further functional analysis as putative aphid effectors.

Abstract The high-pressure and high-temperature structural, mechanical, and dinamical stability of rhodium has been investigated via synchrotron X-ray diffraction using a resistively heated diamond anvil cell and density functional theory. The isothermal compression data have been fitted with a Rydberg-Vinet equation of state (EoS) with best-fitting parameters $$V_0$$ V 0 =55.046(16) Å $$^3$$ 3 , $$K_0$$ K 0 = 251(3) GPa, and $$K'_0$$ K 0 ′ = 5.7(2). The thermal equation of state has been determined based upon the data collected following four different isotherms and has been fitted to a Holland and Powell thermal equation-of-state model with $$\alpha _0=$$ α 0 = 3.36(7)x10 $$^{-5}$$ - 5 K $$^{-1}$$ - 1 . The measured equation of state and structural parameters have been compared to the results of ab initio simulations. The agreement between theory and experiments is generally quite good. The present results solve controversies between previous studies which reported values of the bulk modulus from 240 to 300 GPa.

Abstract Background The complications associated with cardiac device implants ranges between 5.3% and 14.3%. Cardiac perforation due to “leads” represent a very rare complication of cardiac device implantation, ranging between 0.3% and 0.7%. Clinically, they can manifest different, nonspecific symptoms; hence, the diagnosis may not be immediate. Case presentation Our clinical case describes the successful treatment of cardiac tamponade occurring in a Caucasian 79-year-old man following a pacemaker implantation. Two days after the procedure, the patient reported an episode of nonspecific chest pain associated with syncope. The echocardiogram performed revealed a pericardial effusion in the apical area, along the right chambers, with a thickness of 7 mm, not hemodynamically significant. A chest computed tomography scan with contrast showed hemopericardium (maximum thickness of 11 mm), caused by an atrial perforation. A few hours later, the patient experienced hemodynamic instability. For this reason, an urgent sternotomy was performed with drainage of a significant hemopericardial effusion, revealing a perforation of the upper free wall of the right atrium with pericardial injury caused by the retractable screw lead. The perforation site was sutured and the sternal wound was closed. The patient was discharged after 4 days without further complications. At the control visit, scheduled 30 days after the hospital discharge, the patient was in good conditions. Conclusions Although the atrial perforations from leads are very rare complications of pacemaker implantation procedures, they are potentially lethal. In conclusion, this clinical case highlights the need, before hospital discharge, of an accurate screening for evaluation the pericardial effusion in patients that undergo to the cardiac implantable electronic devices.

Abstract Polycyclic aromatic hydrocarbons (PAHs) are classified as environmental and food contaminants, with several adverse health effects, especially genotoxic and carcinogenic actions. In processed meats, they are the major contaminants, especially those subjected to smoking processes. Considering that the population is exposed to PAHs through several routes, and that the ingestion of contaminated food is considered the main one, evaluating the concentrations of these contaminants in food becomes essential, as well as the exposure and risk to the population at different ages through ingestion of the evaluated products. In the current study, the levels of nine PAHs (PAH9) were measured in 205 processed meat products commercially available and with high consumption in Brazil. The methodology involved saponification, extraction with n-hexane, purification with solid-phase extraction (SPE) silica cartridges, and quantification by liquid chromatography with fluorescence detection. In general, 83% of all samples were contaminated with at least one of the studied PAHs, and the measured PAH9 levels ranged between

Abstract In Brazil, there is 13% of the world’s bat diversity, is the second most diverse group of mammals, playing a crucial role in providing ecosystem services that benefit humans. However, anthropogenic disturbances exacerbate processes of species extinction, shifts in geographic distributions, and phenological changes, despite efforts to safeguard biodiversity through the creation of Conservation Units and Indigenous Lands. Moreover, gaps in taxonomic knowledge and challenges related to species distribution hinder the effective implementation of conservation strategies in protected areas. This study assesses the contribution of Brazilian Conservation Units (both Full Protection and Sustainable Use) and Indigenous Lands to the conservation of bat species and their ecosystem services. It also presents maps illustrating species richness by trophic guilds and threat classification according to IUCN, including species listed as Data Deficient. The findings reveal low percentages of potential bat distribution areas within these protected regions, especially for insectivorous, nectarivorous, and frugivorous bats in the Cerrado biome, which are classified as Near Threatened. Additionally, the highest bat species richness was observed in the Amazon and Atlantic Forest biomes.

Abstract Acquisition of specialized cellular features is controlled by the ordered expression of transcription factors (TFs) along differentiation trajectories. Here, we find a member of the Onecut TF family, ONECUT3, expressed in postmitotic neurons that leave their Ascl1 +/Onecut1/2 + proliferative domain in the vertebrate hypothalamus to instruct neuronal differentiation. We combined single-cell RNA-seq and gain-of-function experiments for gene network reconstruction to show that ONECUT3 affects the polarization and morphogenesis of both hypothalamic GABA-derived dopamine and thyrotropin-releasing hormone (TRH)+ glutamate neurons through neuron navigator-2 (NAV2). In vivo, siRNA-mediated knockdown of ONECUT3 in neonatal mice reduced NAV2 mRNA, as well as neurite complexity in Onecut3-containing neurons, while genetic deletion of Onecut3/ceh-48 in C. elegans impaired neurocircuit wiring, and sensory discrimination-based behaviors. Thus, ONECUT3, conserved across neuronal subtypes and many species, underpins the polarization and morphological plasticity of phenotypically distinct neurons that descend from a common pool of Ascl1 + progenitors in the hypothalamus.

Abstract Recovery Colleges (RCs) are learning-based mental health recovery communities, located globally. However, evidence on RC effectiveness outside Western, educated, industrialised, rich, and democratic (WEIRD) countries is limited. This study aimed to evaluate associations between cultural characteristics and RC fidelity, to understand how culture impacts RC operation. Service managers from 169 RCs spanning 28 WEIRD and non-WEIRD countries assessed the fidelity using the RECOLLECT Fidelity Measure, developed based upon key RC operation components. Hofstede’s cultural dimension scores were entered as predictors in linear mixed-effects regression models, controlling for GDP spent on healthcare and Gini coefficient. Higher Individualism and Indulgence, and lower Uncertainty Avoidance were associated with higher fidelity, while Long-Term Orientation was a borderline negative predictor. RC operations were predominantly aligned with WEIRD cultures, highlighting the need to incorporate non-WEIRD cultural perspectives to enhance RCs’ global impact. Findings can inform the refinement and evaluation of mental health recovery interventions worldwide.

One hundred years after the publication of History and Class Consciousness, it is imperative to revisit the classic work of Georg Lukács to discuss the relevance of his ideas in a world where the capitalist mode of production does not cease to show its devastating effects. To do so, we divide the article into two sections. In the first part, we place Lukács’ work in dialogue with that of Hegel and Marx in order to clarify the status of violence as an ontological condition of history, allowing us to determine the theoretical-practical framework from which social revolution can be conceptualized. In the second section, we analyze Lukács’ notion of class consciousness not as a historical fatality but as an act of self-determination of the proletariat. We compare this proposal with the current situation of gentrification of the proletariat which, far from invalidating the Hungarian author’s proposal, constitutes its reversal and the platform for its actualization. Ultimately, it is about the proletarian still today taking control and becoming, through class consciousness, the subject-object of history. We conclude by reinterpreting Lukács’ terms in a practice that counters a reactionary position in order to combat both the reactionary movements and the hedonistic immobilism of the proletariat.

Abstract Background Cancer patients are more susceptible to an aggressive course of COVID-19. Developing biomarkers identifying cancer patients at high risk of COVID-19-related death could help determine who needs early clinical intervention. The miRNAs hosted in the genomic regions associated with the risk of aggressive COVID-19 could represent potential biomarkers for clinical outcomes. Patients and methods Plasma samples were collected at The University of Texas MD Anderson Cancer Center from cancer patients (N = 128) affected by COVID-19. Serum samples were collected from vaccinated healthy individuals (n = 23) at the Municipal Clinical Emergency Teaching Hospital in Timisoara, Romania. An in silico positional cloning approach was used to identify the presence of miRNAs at COVID-19 risk-associated genomic regions: CORSAIRs (COvid-19 RiSk AssocIated genomic Regions). The miRNA levels were measured by RT-qPCR. Results We found that miRNAs were enriched in CORSAIR. Low plasma levels of hsa-miR-150-5p and hsa-miR-93-5p were associated with higher COVID-19-related death. The levels of hsa-miR-92b-3p were associated with SARS-CoV-2 test positivity. Peripheral blood mononuclear cells (PBMC) increased secretion of hsa-miR-150-5p, hsa-miR-93-5p, and hsa-miR-92b-3p after in vitro TLR7/8- and T cell receptor (TCR)-mediated activation. Increased levels of these three miRNAs were measured in the serum samples of healthy individuals between one and nine months after the second dose of the Pfizer-BioNTech COVID-19 vaccine. SARS-CoV-2 infection of human airway epithelial cells influenced the miRNA levels inside their secreted extracellular vesicles. Conclusions MiRNAs are enriched at CORSAIR. Plasma miRNA levels can represent a potential blood biomarker for predicting COVID-19-related death in cancer patients.

Abstract Accumulation of immune cells and proteins in the subarachnoid space (SAS) is found during multiple sclerosis and in the animal model experimental autoimmune encephalomyelitis (EAE). Whether the flow of cerebrospinal fluid (CSF) along the SAS of the spinal cord is impacted is yet unknown. Combining intravital near-infrared (NIR) imaging with histopathological analyses, we observed a significantly impaired bulk flow of CSF tracers within the SAS of the spinal cord prior to EAE onset, which persisted until peak stage and was only partially recovered during chronic disease. The impairment of spinal CSF flow coincided with the appearance of fibrin aggregates in the SAS, however, it preceded immune cell infiltration and breakdown of the glia limitans superficialis. Conversely, cranial CSF efflux to cervical lymph nodes was not altered during the disease course. Our study highlights an early and persistent impairment of spinal CSF flow and suggests it as a sensitive imaging biomarker for pathological changes within the leptomeninges.

The concept of the Metaverse, originating from Neal Stephenson’s 1992 novel Snow Crash, has transitioned from a speculative fiction idea into a complex cultural and technological reality. This paper explores the evolution of the Metaverse as both a digital twin of the physical world and a new ‘cultural logic’ permeating various sectors such as gaming, education, and commerce. By integrating immersive technologies such as virtual reality, the Metaverse offers a blended “phygital” environment where users engage in activities ranging from social interactions to commercial transactions, seamlessly merging physical and digital realities. This study delves into how foremost technology leaders have influenced the Metaverse’s trajectory, focusing on transforming it from a gaming interface to a broad digital ecosystem. We analyze the role of blockchain technology in facilitating a network of interconnected spaces that allow for the preservation of digital identities and assets across platforms, highlighting the challenges and potential of achieving interoperability. Ultimately, this paper presents the Metaverse as a paradigm shift in digital interaction, suggesting future directions where digital and physical realities might further converge. Through a comprehensive review of technological advancements and cultural shifts, we discuss the implications of this convergence for future digital interaction frameworks and societal norms.

It has been established that cross-fostering impacts the development of hypertension in spontaneously hypertensive rats (SHR). However, the ability of the cross-fostering protocol to shape gut microbiota profile in SHR and impact hypertension is not known. In this sense, the current study explored the influence of normotensive and hypertensive postnatal environments on the intestinal microbiota structure, composition, and functional capacity of SHR and Wistar rats. Our findings revealed significant differences in the microbiota's composition and its metabolic activity in young non-fostered SHR (SS) vs. Wistar (WW) rats, even before hypertension onset, characterized by a reduction of the “low-abundance” bacterial genera, a diminished availability of fecal butyrate and elevated hydrogen sulfide (H2S) production by the SS gut microbiota. Despite influencing the microbiota of both strains, cross-fostering did not fully replicate the microbiota composition of the naturally reared groups in the SHR nursed by Wistar mothers (SW), or in the Wistar rats breastfed by SHR mothers (WS). The SW group had fewer significant genera identified at the Partial Least Squares Discriminant Analysis (PLS-DA), despite resembling the genera profile identified in the normotensive group. While sharing bacterial genera with both SS and WW groups, the WS group is distinguished by its unique microbial composition, particularly by a greater diversity of the ‘low-abundance’ bacterial genera. Moreover, decreased systolic blood pressure was observed in the SW group compared to the SS group in adulthood. Thus, we could establish a link between microbiota composition and hypertension development, associating it with the loss of the ''low-abundance'' bacterial taxa. Our data suggest that the postnatal environment is pivotal to promoting gut microbiota compositional changes and contributes to hypertension development.

Abstract Objectives To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in‐hospital stay, readmission rates, 90‐day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resection of bladder tumour (TURBT) in the United States. Patients and Methods Patients aged ≥18 years with a BCa diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de‐identified databases between 2007 and 2021. Multivariable logistic regression adjusted by relevant perioperative confounders was used to investigate the association between diagnosis of VTE before TURBT and 90‐day complication rates, new postoperative VTE events, re‐hospitalization, and total hospital expenditures (2021 US dollars). Sensitivity analyses on VTE severity (pulmonary embolism [PE], deep venous thrombosis [DVT] or superficial thrombophlebitis/phlebitis [SVT]), as well as TURBT extent (minor vs. major) were additionally examined. Results In total, 139 800 patients were identified, with 5.3% having preoperative VTE, including DVT (n = 3112, 42.20%), PE (n = 2046, 27.74%) and SVT (n = 2217, 30.06%). A history of preoperative VTE predicted higher rates of any complication (adjusted odds ratio [aOR] 1.28, 95% CI 1.14–1.43) and also higher rates of infectious and haemorrhagic complications. Additionally, preoperative VTE increased the risk of novel VTE events following TURBT (aOR 17.30, 95% CI 16.05–18.65), hospital length of stay (aOR 2.23, 95% CI 1.90–2.62), readmissions (aOR 1.47, 95% CI 1.39–1.56), and hospital associated costs (aOR 1.17, 95% CI 1.12–1.23). DVT and non‐minor TURBT procedures did not increase the risk of any, infectious, or haemorrhagic complications, but other associations were maintained regardless of the severity of VTE (PE, DVT, SVT) or TURBT extent (minor/major). Conclusions A history of VTE before undergoing transurethral procedures for BCa is associated with significantly worse perioperative outcomes and higher healthcare costs. These findings may help us to counsel on the risks of the intervention and hopefully improve our ability to mitigate such risks.

BackgroundIt has been widely demonstrated that siblings of children with autism spectrum disorder (ASD) have an increased risk of abnormal developmental trajectories. In response to this, early recognition protocols have been developed worldwide, aiming to promote early interventions that can positively impact the neurodevelopment of this population. This paper presents the protocol of a controlled trial: ERI-SIBS (Early Recognition and Intervention in SIBlingS at High Risk for Neurodevelopment Disorders) is an innovative and ecological early recognition and intervention program designed specifically for siblings of children with ASD.MethodsWe aim to recruit siblings at low risk and high risk of neurodevelopmental disorders. Based on clinical evaluation at T0, we will allocate the infants into three groups: Group 1, infants at low risk without any signs of neurodevelopmental disorders; Group 2, infants at high risk without any signs of neurodevelopmental disorders; Group 3: infants at low or high risk with signs suggestive of neurodevelopmental disorders. Children of Group 2 will undergo Active Monitoring (one 90 min session once a month for 6 months), while children of Group 3 will undergo Early Intervention (one 90 min session once a week for 6 months). In both cases, the ERI-SIBS contents are based on a multidimensional and naturalistic approach and always involve caregivers. All recruited children will be evaluated at three different time points (T0 within the 8 months of life of the child, T1 after 6 months and T2 after 12 months) using behavioural, technological, and biological techniques to assess infants’ neurodevelopmental functions, parent-infant interaction, and early ASD markers.DiscussionThe ERI-SIBS study will expand knowledge regarding the impact of early intervention on families of infants at risk of neurodevelopmental disorders for the presence of a child with a diagnosis of ASD. The study will have the potential to significantly contribute to future research and the scientific and clinical debate on the best way to implement early intervention in at-risk populations. Clinical Trial RegistrationClinicaltrials.gov identifier (NCT06512649).

BackgroundBy allowing for abortion bans and restrictions to take effect in the majority of US states, the 2022 Dobbs v Jackson Women’s Health Organization decision portends to have lasting impacts on patient care and the physician workforce. Notably, it is already beginning to impact practice location preferences of US health care workers, evidenced by declining application rates to residency programs in abortion-restrictive states since 2022. Yet, there remains a gap in the literature regarding why this trend exists. ObjectiveThis study aims to describe what factors are driving the practice location preferences of medical students and physicians after the Dobbs decision. MethodsThis study analyzes qualitative data from a web-based, cross-sectional study. In August 2022, a nonprobabilistic sample of physicians and medical students were surveyed on social media about the impact of overturning Roe v Wade on practice location preferences, which included the free-text question “Please share your thoughts about the overturning of Roe v Wade and how it will affect your decision about your (residency/job or fellowship) programs.” A total of 3 independent team members completed an inductive thematic analysis of 524 free responses, resolving differences by discussion. ResultsApproximately 1 in 4 survey respondents also completed the free-response item (524/2063, 25.4%); a total of 219 were medical students, 129 were residents and fellows, and 176 were practicing physicians. Of them, approximately half (261/524, 50.5%) resided in states where abortion bans were in place or anticipated. Those who answered the free-response item were relatively more likely to hail from states with restrictive abortion bans (P

Objetivos: analisar a assistência pré-natal do enfermeiro às gestantes com diagnóstico de sífilis na atenção primária à saúde. Métodos: estudo transversal, realizado com enfermeiros da Estratégia Saúde da Família de uma regional de saúde, em São Paulo. A coleta de dados online foi realizada a partir de questionário baseado nos protocolos ministeriais deassistência à sífilis na gestação. Para análise aplicou-se o teste Exato de Fisher e o Teste Qui-quadrado (p < 0,05). Resultados: participaram 89 enfermeiros, todos realizavam o primeiro atendimento pré-natal, contudo 29,2% referiram não realizar consultas pré-natais subsequentes. Entre os enfermeiros que realizavam as consultas subsequentes, 81,2% baseavam sua assistência em protocolo municipal (p = 0,000); 32,2% não realizavam a prescrição de Benzilpenicilina benzatina para as gestantes reagentes para sífilis e 22,7% não administravam o fármaco sem a presença do médico na unidade. Observou-se ainda aprescrição de protocolo único de tratamento para as gestantes independentemente do estágio da sífilis que se encontravam. Conclusão: há lacunas e não conformidades emrelação aos protocolos na assistência prestada pelos enfermeiros às gestantes com diagnóstico de sífilis, evidenciando a necessidade de ações para melhorias na prática dos enfermeiros da atenção primária à saúde e monitoramento da conformidade com os protocolos instituídos.

IntroductionTuberculosis (TB) is the deadliest infectious disease worldwide and novel vaccines are urgently needed. HLA-E is a virtually monomorphic antigen presentation molecule and is not downregulated upon HIV co-infection. HLA-E restricted Mtb specific CD8+ T cells are present in the circulation of individuals with active TB (aTB) and Mtb infection (TBI) with or without HIV co-infection, making HLA-E restricted T cells interesting vaccination targets for TB.MethodsHere, we performed in-depth phenotyping of HLA-E/Mtb specific and total T cell populations in individuals with TBI and in individuals with aTB or TBI and HIV using HLA-E/Mtb tetramers.Results and DiscussionWe show that HIV co-infection is the main driver in changing the memory distribution of HLA-E/Mtb specific CD4+ and CD8+ T cell subsets. HLA-E/Mtb specific CD4+ and CD8+ T cells were found to circulate with comparable frequencies in all individuals and displayed expression of KLRG1, PD-1 and 2B4 similar to that of total T cells. The presence of HLA-E/Mtb specific T cells in individuals with aTB and TBI highlights the potential of HLA-E as a vaccine target for TB.

Este estudo investiga a formação docente para a inclusão nos cursos de licenciatura da UFES/Alegre, com foco nos Projetos Pedagógicos de Curso (PPCs) e nas diretrizes curriculares. Adotando uma abordagem qualitativa, a pesquisa utiliza análise documental dos PPCs e grupos focais com professores e coordenadores. Os resultados revelam que, embora as diretrizes de inclusão estejam presentes nos PPCs, a implementação prática da inclusão nas disciplinas pedagógicas enfrenta desafios, como a falta de preparação específica dos docentes. Identificou-se também que a interdisciplinaridade e a formação continuada são vistas como essenciais para superar tais desafios. A análise sugere que, apesar dos avanços, a formação docente ainda carece de uma abordagem mais integrada e eficaz para garantir a inclusão real de estudantes com deficiência, o que demanda uma reavaliação das práticas pedagógicas e das políticas educacionais.

Abstract: Aim The study investigated functional groups representing reservoirs of different trophic states, identifying eutrophication indicators. Methods Water samples were collected to evaluate physical and chemical characteristics and the phytoplankton composition in five reservoirs during dry and rainy periods. Results Low concentration of dissolved nutrients (nitrite, orthophosphate, and total dissolved phosphorus) and total phosphorus described the oligotrophic and mesotrophic reservoirs, and the opposite for the eutrophic and hypertrophic reservoirs. Twenty-four functional groups were identified, eight of which were considered descriptors due to high biomass. Functional groups were influenced by the trophic state, and secondarily by seasonality. Typical functional groups represented the hypertrophic, eutrophic, and mesotrophic reservoirs. However, an oligotrophic reservoir was represented by a functional group commonly associated with environmental eutrophic. Conclusions The functional groups were representative of the trophic state of systems and detected signs of early eutrophication.

Abstract Celtis australis L. (Family: Cannabaceae) is commonly used to treat many diseases like gastrointestinal problems, menstrual bleeding and amenorrhea. The present study was designed to investigate the chemical constituents, antioxidant, enzyme inhibitory and cytotoxic properties of different extracts from twigs, fruits and leaves of C. australis. EtOAc, EtOH, 70% EtOH and aqueous extracts were prepared by maceration. Results showed that the EtOH extract of the leaves had the highest total phenolic content and possessed remarkable antiradical, ion reducing and total antioxidant activities. Additionally, the leaves (EtOH or EtOAc extracts) exerted the best enzyme inhibition properties. The polar extracts of the leaves had significant cytotoxic effect against the human colorectal adenocarcinoma (HT‐29) and human prostate cancer (DU‐145) cell lines while the EtOAc of the twigs was effective against the former cell line. Phytochemically, the twigs and fruits accumulated high content of vanillic acid, 4‐hydroxy benzoic acid and syringic acid. Through a combination of in vitro and in silico approaches, we identified key phytochemicals exhibited significant inhibitory effects on several cancer‐related proteins, through in vitro and in silico approaches that show significant inhibition of cancer‐related proteins. In conclusion, these findings indicated that C. australis could be a promising source of bioactive molecules for food, pharmaceutical and cosmetic industries.

Este artigo oferece uma visão atual sobre o alinhamento estratégico da comunicação organizacional nas instituições da Rede Federal de Educação Profissional, Científica e Tecnológica (RFEPCT). O estudo explora a importância de uma comunicação clara, transparente e inclusiva como um pilar estratégico essencial para o sucesso e a eficácia institucional. Através de uma abordagem exploratória baseada em revisão bibliográfica, a pesquisa examina como a comunicação se integra ao planejamento estratégico nas instituições, com foco na referida área hoje existente na rede federal de ensino. A análise evidencia que a falta de uma comunicação eficaz pode comprometer o alcance dos objetivos institucionais, resultar em processos ineficazes e prejudicar a imagem institucional. Conclui-se que a integração estratégica da comunicação e a profissionalização das ferramentas comunicativas são cruciais para garantir a transparência, fortalecer a reputação e apoiar a gestão estratégica das instituições da RFEPCT.

Este trabalho objetiva discutir as contradições presentes entre o Ensino Médio Integrado e o Novo Ensino Médio. Busca também identificar os riscos que esse novo modelo traz para os cursos ofertados pelos Institutos Federais (IFs) referentes à última etapa da Educação Básica. Para tanto, baseia-se numa análise qualitativa bibliográfica e de dados quantitativos extraídos da Plataforma Nilo Peçanha (PNP) de todos os IFs do Brasil. Conclui-se que a adesão, mesmo que parcial, dos IFs ao Novo Ensino Médio compromete a oferta de uma formação integral e integrada.

Multi-component materials/compounds and polymeric/composite systems pose structural complexity that challenges the conventional methods of molecular representation in cheminformatics, which have limited applicability in such cases. Therefore, we have introduced an innovative structural representation technique tailored for complex materials. We implemented different mixing rules based on linear and nonlinear relationships’ additive effect of different components in composites treating each multi-component material as a mixture system. We developed and improved mixture descriptors based on 12 different mixture functions grouped into three main categories: property-based descriptors, concentration-weighted descriptors, and deviation-combination descriptors. A python package was developed for this purpose, allowing users to compute 12 different mixture-descriptors to use as input for the generation of mixture-based Quantitative Structure-Activity/Property Relationship (mxb-QSAR/QSPR) machine learning models for predicting a range of chemical and physical properties across various complex systems.

This study investigated the social representations of primary school teachers who teach Natural Sciences in the early years of elementary education regarding the Inquiry-Based Science Teaching approach. Within the context of a continuing education course offered as an extension course at a public university in São Paulo state, a free-association questionnaire was used as a data collection instrument. Each of the 101 teachers was asked to list six words they remembered when reading the inducing term "Inquiry-Based Science Teaching." After being tabulated and grouped by theme, the responses were subjected to the openEvoc 0.95 and IRaMuTeQ software analysis. The results suggest that the terms "Research" and "Curiosity" are part of the Central Core of the Social Representation of the participants. Additionally, when analyzing the most frequently mentioned terms, it becomes evident that experiment is an intrinsic aspect of Investigative Teaching in the conception of this group of participants

Abstract Background Depression is a common mental disorder. Detecting (sub)clinical depressive symptoms in adolescents at an early stage and offering a low-threshold early intervention can minimize the risk of serious and/or long-term depression. As such, a digital intervention can be a low-threshold preventive and early intervention. This study aims to examine whether the Boost My Mood (BMM)-app is a suitable preventive early intervention for adolescents with (sub)clinical depressive symptoms. Methods This naturalistic single-arm evaluation study (N = 50) was conducted in adolescents aged 16–21 with (sub)clinical depressive symptoms. Furthermore, the BMM-app was studied in relation to anxiety, worrying, stress, and sleeping problems. An exploratory objective was to determine whether positive expectations and social support are related to app use. Results The study showed a significant decrease in not only depressive symptoms, but also anxiety, worrying and stress while using the BMM-app. Sleeping problems did not significantly decrease over time while using the BMM-app. The degree of use of the BMM-app and telling significant others about using the BMM-app were both not related to a decrease in depressive symptoms. The BMM-app was used significantly more when the adolescent had told relatives about their depressive symptoms. Conclusions A digital intervention, such as the BMM-app, can be a low-threshold preventive and early intervention for adolescents with (sub)clinical depressive symptoms. Beneficial effects of the BMM-app were reported on depressive symptoms as well as other aspects of quality of life, such as anxiety, worrying, and stress. Whereas several factors may have played a role in the current findings on depressive symptoms, there are reasons to assume that part of the reduction in symptoms could be attributed to the BMM-app. Although no causality can be assumed, this study is a first step in the implementation of preventive apps in mental health care.

Abstract Segmentation of brain structures on magnetic resonance imaging (MRI) is a highly relevant neuroimaging topic, as it is a prerequisite for different analyses such as volumetry or shape analysis. Automated segmentation facilitates the study of brain structures in larger cohorts when compared with manual segmentation, which is time-consuming. However, the development of most automated methods relies on large and manually annotated datasets, which limits the generalizability of these methods. Recently, new techniques using synthetic images have emerged, reducing the need for manual annotation. Here we provide a dataset composed of label maps built from publicly available ultra-high resolution ex vivo MRI from 10 whole hemispheres, which can be used to develop segmentation methods using synthetic data. The label maps are obtained with a combination of manual labels for the hypothalamic regions and automated segmentations for the rest of the brain, and mirrored to simulate entire brains. We also provide the pre-processed ex vivo scans, as this dataset can support future projects to include other structures after these are manually segmented.

Introduction: Nowadays, there is insufficient evidence for the recommendation of management patients with a primary membranoproliferative glomerulonephritis (MPGN). A better understanding of the pathogenesis has led to the reclassification of primary MPGN and distinction into the two main entities of either primary immune complex-MPGN or C3 glomerulopathy. Both entities share overlapping pathophysiological features with complement alternative pathway (AP) dysregulation. Iptacopan is an oral inhibitor of the complement factor B that effectively blocks the complement AP. Case Presentation: We report the first successful treatment of a 47-year-old man suffering from a primary immune complex-MPGN with iptacopan. So far established immunosuppressive therapies with prednisone and mycophenolate mofetil failed to control the current flare of the disease, mainly presenting with impaired kidney function and proteinuria within the nephrotic range. However, 3 months after starting the treatment with iptacopan urine protein-creatinine ratio decreased impressively to a level of 100–150 mg/mmol. Thereafter, low-level proteinuria and kidney function remained stable during follow-up. Do date, the treatment with iptacopan is continued as a monotherapy and is well tolerated. Conclusion: To the best of our knowledge, this is the first case report which suggests that iptacopan may be an interesting treatment option for primary immune complex-MPGN.

Despite the advent of robotics and the decreasing rate of complications after radical cystectomy, several factors are renowned to impair the early outcomes of this procedure. The aim of this paper is to provide a multivariate analysis (MVA) of patient and surgical procedure-related variables likely to affect postoperative course and 30-day complication rate. Fifty-five robotic-assisted radical cystectomies (RARCs) performed at a single center from July 2021 to March 2023 were enrolled. Baseline demographics, comorbidities, and intraoperative and postoperative data were collected. Uni- and multivariate analyses were performed to evaluate the relationship with Clavien ≥ II complications arising within 30 days of surgery. A postoperative Clavien ≥ II complication was evident in 15 patients (28%), whereas Clavien ≥ III occurred only in 5 (9%). At MVA, the only independent predictor of Clavien ≥ II complications was a prior neoadjuvant chemotherapy (OR 5.6; 95% CI 1.22–25.3, p = 0.026). Recognized the small sample size, patients who received a prior NAC should deserve special care within the postoperative course.

Abstract Sjogren’s disease (SjD) is an autoimmune disease that is characterized not only by the sicca symptoms it causes but also by its systemic nature, which is capable of several and not yet fully understood extraglandular manifestations. To gain a clearer understanding of these manifestations as well as a better practical approach, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of the extraglandular manifestations present in ESSDAI (EULAR Sjogren´s syndrome disease activity index), followed by a voting panel with recommendations for clinical practice. This publication is complementary to others already published and covers cutaneous and hematological manifestations, with prevalence data generated by a meta-analysis of 13 clinical or laboratory manifestations and 6 clinical management recommendations.

Abstract SARS-CoV2 infection results in a range of disease severities, but the underlying differential pathogenesis is still not completely understood. At presentation it remains difficult to estimate and predict severity, in particular, identify individuals at greatest risk of progression towards the most severe disease-states. Here we used advanced models with circulating serum analytes as variables in combination with daily assessment of disease severity using the SCODA-score, not only at single time points but also during the course of disease, to correlate analyte levels and disease severity. We identified a remarkably strong pro-inflammatory cytokine/chemokine profile with high levels for sCD163, CCL20, HGF, CHintinase3like1 and Pentraxin3 in serum which correlated with COVID-19 disease severity and overall outcome. Although precise analyte levels differed, resulting biomarker profiles were highly similar at early and late disease stages, and even during convalescence similar biomarkers were elevated and further included CXCL3, CXCL6 and Osteopontin. Taken together, strong pro-inflammatory marker profiles were identified in patients with COVID-19 disease which correlated with overall outcome and disease severity.

Introduction: Acute upper gastrointestinal bleeding is one of the most common medical emergencies that present to the hospital, and delineating the underlying etiology is essential to provide adequate definitive treatment. The purpose of this case report was to review the diagnosis and treatment of a rare complication known as radiation-induced hemorrhagic gastritis (RIHG) that can occur in patients with prior radiation exposure. The motivation for this study arose from the identification of a case within our institution. Case Presentation: The study involved a review of the diagnosis and management of a patient who presented with anemia and recurrent episodes of gastrointestinal bleeding at our institution after undergoing treatment for metastatic biliary adenocarcinoma. With the advent of new therapies, we aimed to investigate the various techniques utilized to manage these patients and highlight the importance of maintaining a high index of suspicion for RIHG as a potential etiology of gastrointestinal bleeding in patients with a relevant medical history of radiation exposure. Despite the literature review, we found that there is a lack of guidelines in the approach to the management of these patients. Conclusion: This case report underscores the rarity of radiation-induced gastritis and the complications that may arise from its diagnosis, including recurrent GI bleeding. Further investigation into identifying definitive treatment and creating guidelines for its management is desperately needed.

Abstract Objective To develop the second evidence-based Brazilian Society of Rheumatology consensus for diagnosis and treatment of lupus nephritis (LN). Methods Two methodologists and 20 rheumatologists from Lupus Comittee of Brazilian Society of Rheumatology participate in the development of this guideline. Fourteen PICO questions were defined and a systematic review was performed. Eligible randomized controlled trials were analyzed regarding complete renal remission, partial renal remission, serum creatinine, proteinuria, serum creatinine doubling, progression to end-stage renal disease, renal relapse, and severe adverse events (infections and mortality). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to develop these recommendations. Recommendations required ≥82% of agreement among the voting members and were classified as strongly in favor, weakly in favor, conditional, weakly against or strongly against a particular intervention. Other aspects of LN management (diagnosis, general principles of treatment, treatment of comorbidities and refractory cases) were evaluated through literature review and expert opinion. Results All SLE patients should undergo creatinine and urinalysis tests to assess renal involvement. Kidney biopsy is considered the gold standard for diagnosing LN but, if it is not available or there is a contraindication to the procedure, therapeutic decisions should be based on clinical and laboratory parameters. Fourteen recommendations were developed. Target Renal response (TRR) was defined as improvement or maintenance of renal function (±10% at baseline of treatment) combined with a decrease in 24-h proteinuria or 24-h UPCR of 25% at 3 months, a decrease of 50% at 6 months, and proteinuria

Summary: Background: Carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), Pseudomonas aeruginosa (CRPA), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE) are listed by World Health Organization (WHO) as priority antimicrobial-resistant bacteria. Data on WHO Priority Antimicrobial resistance Phenotype (WPAP) bacteria from low- and middle-income countries are scarce. In this study, we investigated the occurrence of WPAP in healthcare-associated bloodstream infections (BSI) in Brazil, an upper-middle-income country in South America. Methods: ASCENSION was a prospective, multicentre, observational study conducted in 14 hospitals from four of five Brazilian regions. Enterobacterales, A. baumannii, P. aeruginosa, S. aureus and E. faecium BSIs in hospitalised patients were analysed. The primary outcome was the frequency of WPAP among all bacteria of interest. Secondary outcomes were incidence-density of bacteria isolates in hospitalised patients, WPAP proportions within bacterial species, and 28-day mortality. PCR for carbapenemase genes was performed in carbapenem-resistant Gram-negative bacteria. Findings: Between August 15, 2022, and August 14, 2023, 1350 isolates (1220 BSI episodes) were included. WPAP accounted for 38.8% (n = 524; 95% Confidence Interval 32.0–46.1) of all isolates, with CRE (19.3%) as the most frequent, followed by CRAB (9.6%), MRSA (4.9%), VRE (2.7%), and CRPA (2.4%). Incidence-density of all and WPAP isolates were 1.91 and 0.77/1000 patients-day, respectively. Carbapenem-resistant Klebsiella pneumoniae (CRKP) was the most common CRE, corresponding to 14.2% of all BSIs. A. baumannii isolates presented the highest proportion of WPAP (87.8%). Mortality rates were higher in patients with BSIs by WPAP than non-WPAP isolates. KPC (64.4%) was the predominant carbapenemase in CRE, followed by NDM (28.4%) and KPC + NDM co-production (7.1%). OXA-23 was the most frequent in CRAB. Interpretation: A high frequency of WPAP bacteria, particularly CRKP and CRAB, were found in healthcare-associated BSIs in Brazil, posing them as a major public health problem in this country. Funding: National Council for Scientific and Technological Development, Brazil.

We herein present a video of a robotic-assisted uretero-ileal reimplantation in an ileal conduit. The patient was a 74 year old male who had undergone robotic assisted radical cystectomy with intracorporeal ileal conduit in 2022. Pathology showed urothelial cell carcinoma pT2N0. In amrch 2023 the patient was admitted in our clinic with left side flank pain and sepsis. A CT scan showed severe lefthydronephrosis on a left sided uretero-ileal stricture. A nephrostomy tube was patient and, after management of sepsis, an endoscopic balloon dilatation of the stricture was performed in may 2023. Patient experienced a stricture recurrence in September 2023. We thus decided to perform robotic assisted uretero-ilal reimplantation.Patient was positions in dorsal decubitus and robotic trocarts were positioned as for radical cystectomy. Extensive adhesiolysis was performed. A stay suture was then positioned on the ileal conduit to traction it towards the abdominal wall. Dissection of the retroperitoneum was then performed medial to the ileal conduit, in order to identify the left ureter. The right ilac vessels are exposed to avois inadvertent injury. ICG is instilled via the left nephrostomy, helping the surgeon to identify the left ureter. Gven the massive fibrosis of the ureter, this structure is not mobilized and the ileal loop is brought down to the ureter. A side to side anastomosis is performed using 4/0 vycril. A 7F monoJ catheter is positioned and externalized using a foley catheter as carrier. OR time was 155 minuted and estimated blood loss 50cc. Post operative course was uneventful and patient was discharged on POD 2.

Abstract Lentiviral vectors (LV) are efficient vehicles for in vivo gene delivery to the liver. LV integration into the chromatin of target cells ensures their transmission upon proliferation, thus allowing potentially life-long gene therapy following a single administration, even to young individuals. The glycoprotein of the vesicular stomatitis virus (VSV.G) is widely used to pseudotype LV, as it confers broad tropism and high stability. The baculovirus-derived GP64 envelope protein has been proposed as an alternative for in vivo liver-directed gene therapy. Here, we perform a detailed comparison of VSV.G- and GP64-pseudotyped LV in vitro and in vivo. We report that VSV.G-LV transduced hepatocytes better than GP64-LV, however the latter showed improved transduction of liver sinusoidal endothelial cells (LSEC). Combining GP64-pseudotyping with the high surface content of the phagocytosis inhibitor CD47 further enhanced LSEC transduction. Coagulation factor VIII (FVIII), the gene mutated in hemophilia A, is naturally expressed by LSEC, thus we exploited GP64-LV to deliver a FVIII transgene under the control of the endogenous FVIII promoter and achieved therapeutic amounts of FVIII and correction of hemophilia A mice.

Abstract Background The analysis of large and complex biological datasets in bioinformatics poses a significant challenge to achieving reproducible research outcomes due to inconsistencies and the lack of standardization in the analysis process. These issues can lead to discrepancies in results, undermining the credibility and impact of bioinformatics research and creating mistrust in the scientific process. To address these challenges, open science practices such as sharing data, code, and methods have been encouraged. Results CREDO, a Customizable, REproducible, DOcker file generator for bioinformatics applications, has been developed as a tool to moderate reproducibility issues by building and distributing docker containers with embedded bioinformatics tools. CREDO simplifies the process of generating Docker images, facilitating reproducibility and efficient research in bioinformatics. The crucial step in generating a Docker image is creating the Dockerfile, which requires incorporating heterogeneous packages and environments such as Bioconductor and Conda. CREDO stores all required package information and dependencies in a Github-compatible format to enhance Docker image reproducibility, allowing easy image creation from scratch. The user-friendly GUI and CREDO's ability to generate modular Docker images make it an ideal tool for life scientists to efficiently create Docker images. Overall, CREDO is a valuable tool for addressing reproducibility issues in bioinformatics research and promoting open science practices.

A Educação necessita abordar as atividades científicas e tecnológicas de modo a proporcionar aos estudantes meios de compreender e avaliar suas influências sobre diversos parâmetros que caracterizam a sociedade. Neste sentido, a educação sob a perspectiva Ciência,Tecnologia e Sociedade (CTS), pode promover a adoção de valores e atitudes que lhes permitam interpretar e se posicionar frente a essas atividades tendo em vista os efeitos da globalização, dos sistemas de produção e consumo e a necessidade de transformarmos a realidade social e ambiental, buscando uma melhor qualidade de vida e a sustentabilidade. Portanto, a investigação em tela tem objetivo de identificar a Representação Social (RS) de estudantes da educação básica sobre o ambiente marinho, utilizando as contribuições de Moscovici e a teoria do núcleo central proposta por Abric. Do ponto de vista metodológico, procurou-se identificar a RS de 299 estudantes que se encontram na faixa etária entre 11 e 16 anos, regularmente matriculados no 7ºano, 8ºano e 9ºano do ensino fundamental, de duas escolas brasileiras. Como instrumento de coleta de dados os estudantes tinham que responder à seguinte questão: Ao pensar nos mares e oceanos, quais são as seis primeiras palavras que vem à sua mente? A partir da análise dos dados percebeu-se que mesmo sendo o Brasil um país conhecido por ter uma extensa área litorânea, as respostas dos estudantes revelam a existência de um distanciamento considerável em relação a tal ambiente.

Abstract In this study, the effect of halide anions on the selectivity of the CO2 reduction reaction to CO was investigated in choline‐based ethylene glycol solutions containing different halides (ChCl : EG, ChBr : EG, ChI : EG). The CO2RR was studied using silver (Ag) and gold (Au) electrodes in a compact H‐cell. Our findings reveal that chloride effectively suppresses the hydrogen evolution reaction and enhances the selectivity of carbon monoxide production on both Ag and Au electrodes, with relatively high selectivity values of 84 % and 62 %, respectively. Additionally, the effect of varying ethylene glycol content in the choline chloride‐containing electrolyte (ChCl : EG 1 : X, X=2, 3, 4) was investigated to improve the current density during CO2RR on the Ag electrode. We observed that a mole ratio of 1 : 4 exhibited the highest current density with a comparable faradaic efficiency toward CO. Notably, an evident surface reconstruction process took place on the Ag surface in the presence of Cl− ions, whereas on Au, this phenomenon was less pronounced. Overall, this study provides new insights into anion‐induced surface restructuring of Ag and Au electrodes during CO2RR, and its consequences on the reduction performance on such surfaces in non‐aqueous electrolytes.

Introdução e objetivo: infecções fúngicas invasivas continuam sendo um desafio para pacientes hospitalizados, com alta mortalidade. Na pandemia de COVID-19, observou-se um aumento das infecções causadas por leveduras. O objetivo deste trabalho foi avaliar a epidemiologia das candidemias após a diminuição da pandemia. Material e métodos: De 2017-2019 (período pré-pandemia), 2020-2022 (durante) e 2023-2024 (após), todas as hemoculturas positivas no sistema BactAlert® ao exame direto para leveduras foram encaminhadas ao Laboratório de Micologia para serem identificadas pelos métodos tradicionais (auxanograma e zimograma) e automatizado (Vitek2®). Uso do meio de Chromoagar®, Chromoagar plus® ou Malditof® foram utilizados para determinação da espécie de Candida. Apenas os pacientes assistidos no hospital foram acompanhados; somente a primeira hemocultura de cada paciente foi considerada; dados clínicos e epidemiológicos foram avaliados. A incidência anual de candidemia foi calculada considerando o número de admissões hospitalares. As diferenças entre as incidências foram calculadas pelo método de Poisson; valor de p < 0,05 foram considerados significativos. Resultados: 166 episódios foram acompanhados desde 2017. A incidência de candidemia variou de 1,2 episódios por 1000 admissões (pré-pandemia), 4,3 (durante a pandemia) a 2,7 (após). As espécies mais frequentes continuam sendo C. albicans (n = 57), C. parapsilosis (n = 47), C. tropicalis (n = 41) e C. glabrata (n = 16). Duas cepas de C. haemulonii e uma C. pelliculosa foram confirmadas. Nenhuma cepa foi identificada como C. auris. A incidência de candidemia aumentou desde o início da pandemia (de 1,2 para 2,8; p = 0,0001) e considerando apenas os pacientes que não tiveram COVID-19, manteve-se alta (2,5; p = 0,6). A incidência de C. albicans e C. tropicalis voltou ao nível da pré-pandemia (0,9 e 0,3; respectivamente). Entretanto, a incidência de C. parapsilosis aumentou de 0,3 (pré-pandemia) para 1,2 (pós-pandemia; p = 0,0015). Os pacientes com infecção por C. parapsilosis não tiveram relação temporal ou espacial. Após o início da pandemia, observamos que a maioria destes pacientes foram procedentes de clínicas de hemodiálise. Conclusões: Após a diminuição da pandemia, a incidência de candidemia se manteve alta nos pacientes hospitalizados. Candida parapsilosis emergiu como patógeno mais prevalente. Palavras-chave: Candidemia, Epidemiologia, COVID-19. Conflitos de interesse: Nenhum autor tem conflitos de interesse. Ética e financiamentos: Sem financiamento especifico. Projeto aprovado pelo CEP HUCFF

Introdução: A resistência antimicrobiana é uma preocupação mundial e estratégias para melhor uso de antibióticos são necessárias, apesar da gravidade dos pacientes em UTIs (Unidade de Terapia Intensiva). O objetivo foi avaliar o impacto de medidas restritivas no uso de antimicrobianos e da pandemia COVID-19 na incidência de bactérias multirresistentes (MDR) e mortalidade dos pacientes numa UTI privada no Rio de Janeiro. Materiais/métodos: série temporal, entre 2013 e 2021, com intervenção restritiva (a partir de 2017) na posologia e tempo de uso dos antimicrobianos (amicacina, aztreonan, cefepime, ceftarolina, ciprofloxacina, ertapenem, meropenem, piperacilina/tazobactam, polimixina B, tigeciclina). A ocorrência de Enterobacterales (ERC) e Pseudomonas (PRC) resistentes aos carbapenemas, Enterobacterales produtoras de ESBL por 1000 pacientes-dia (p-dia) e a mortalidade foram analisadas pelo Modelo Dinâmico Generalizado com Resposta Poisson. Para analisar o efeito da pandemia, utilizou-se a razão das admissões de pacientes com COVID-19/total de admitidos como uma das variáveis regressoras. A diária de utilização de ventilação mecânica (VM) por 100 p-dia foi utilizada para a gravidade estimada dos pacientes. Para o consumo de antimicrobianos em DDD/100 p-dia, foi utilizado o modelo aditivo generalizado. Resultados: Através da análise bayesiana houve redução dos óbitos de -29% IC [-37 a -21] com probabilidade de redução (P ≤ 0) de 100%; na ocorrência de MDRs, obtivemos redução em: ERC -38% IC [-95 a 19] (P ≤ 0) 85%; PRC -34 IC [-53 a -14] (P ≤ 0) 99,7%, durante a intervenção. Após a pandemia, houve redução em PRC -72% IC [-106 a -38] e ESBL -84% IC [-102 a -66] com (P ≤ 0) de 98 e 100%, respectivamente. Não houve diferença na gravidade entre os períodos anterior e posterior a intervenção. Houve redução no consumo de Meropenem, estimativa pontual (EP) -14 IC [-25 a -3] e na soma de todos os antimicrobianos -21 IC [-38 a - 4] ambos com p valor < 0,02. Conclusão: a restrição de antimicrobianos não aumentou a mortalidade dos pacientes. Observamos impacto na diminuição de MDR mesmo após a pandemia de COVID-19. Palavras-chave: Antimicrobial Stewardship, Mortality, Intensive Care Unit, Multidrug Resistant. Conflitos de interesse: Não há conflitos de interesse. Ética e financiamentos: Não há nada a declarar