Search

The growing need for sustainable wastewater treatment solutions has led to exploring alternative materials to explore large-scale and reliable technologies. This study focuses on optimizing the synthesis of geopolymers based on fly ash using a Box-Behnken experimental design to enhance their adsorption efficiency for phenolic compounds, as gallic acid model pollutant which are widely found in wastewater leaching from landfills. Fifteen geopolymer samples were synthesized, characterized, and tested for adsorption performance. Various techniques were employed, including X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infrared (FT-IR) spectroscopy. The optimization process highlighted the significance of the Si/Al mass ratio, NaOH molar concentration, and Na₂SiO₃/NaOH as variables in the geopolymers production. Geopolymer samples demonstrated significant adsorption capacities, with GP_2.0_10_2.5 achieving a maximum adsorption capacity of 75.8 mg g-1. Kinetic studies indicated that the pseudo-first-order model best described the adsorption process. At the same time, equilibrium data fitted well with both Langmuir and Freundlich isotherms, with GP_2.0_10_2.5 showing the best fit for the Langmuir model. These findings reveal the potential of geopolymers derived from fly ash as cost-effective adsorbents in wastewater treatment, promoting the reuse of industrial waste within the framework of a Circular Economy.

Introduction: External beam radiotherapy (EBRT) became unavailable in Uganda from February 2016 to November 2017. Following resource stratification guidelines, an alternative treatment strategy was developed. Methods: Bulky early stage to Stage IIIB patients received at least 3 cycles of neoadjuvant chemotherapy (NAC). Surgery was performed if adequate response was achieved and adjuvant therapy given for high risk factors. Chemotherapy versus supportive care was advised in unresectable disease. NAC protocol completion was defined as receiving at least 3 cycles of NAC followed by either surgery, chemotherapy and/or radiation, or best supportive care. The purpose of this study was to determine the completion rate of NAC and assess the adverse events associated with treatment. Data were collected through retrospective chart review. Results: From February 2016 to November 2018, 53 evaluable patients were identified. 86.8% (46/53) of patients presented in Stage IIB or higher. The completion rate of the NAC protocol was 75.5% (40/53). 94.3% (50/53) received platinum-taxane combination. 7.6% (4/52) grade 3 adverse events occurred related to chemotherapy, all hematologic. 18.8% (10/53) patients underwent surgery with 2 aborted cases due to metastatic or inoperable disease. No adverse events related to surgery were reported. 5 patients underwent adjuvant therapy after surgery due to high risk factors or incomplete pathology findings. 26 patients received adjuvant radiation (3 brachytherapy, 23 EBRT after it became available). Reported side effects related to radiation included vaginal fibrosis and skin reactions. Conclusion: In this limited-resource setting, majority of patients completed a NAC treatment strategy for cervical cancer with acceptable toxicities.

We developed a novel adeno-associated virus 5 gene therapy (AAV5-GLA) expressing human alpha-galactosidase A (GLA) under the control of a novel, small and strong, liver-restricted promoter. We assessed the preclinical potential of AAV5-GLA for treating Fabry disease, an X-linked hereditary metabolic disorder resulting from mutations in the gene encoding GLA that lead to accumulation of the substrates globotriaosylceramide and globotriaosylsphingosine, causing heart, kidney, and central nervous system dysfunction. Effects of intravenously administered AAV5-GLA were evaluated in (1) GLA-knockout mice aged 7–8 weeks (early in disease) and 20 weeks (nociception phenotype manifestation) and (2) cynomolgus macaques during an 8-week period. In both species, AAV5-GLA was observed as safe, generated detectable vector DNA and mRNA levels in liver, and produced stable enzyme activity in liver and plasma. In mice, dose-dependent transgene enzyme activity, cross-correction (substrate reduction) in kidney and heart, and improved nociception lasted over 6 months. Moreover, after delayed administration when animals displayed the nociception phenotype, target organ enzyme activity was present, and accumulated substrates were reduced. Given the strong, durable expression of active GLA with this promoter and favorable profile of adeno-associated virus 5-based gene therapy in humans, AAV5-GLA warrants further investigation in clinical trials for Fabry disease.

Objective: Serious games can serve as easily accessible interventions to support siblings of children with disabilities, who are at risk of developing mental health problems. The Dutch serious game ‘Broodles’ was developed for siblings aged 6–9 years. The current study aims to assess the cultural applicability, desirability, feasibility, and acceptability of ‘Broodles’ in Norway. Methods: Norwegian siblings (N = 16) aged 6–13 years and parents (N = 12) of children with intellectual disabilities assessed the game. Their feedback data from interviews and questionnaires were sorted using a model of engagement factors in serious games. Results: At pre-use, participants showed interest in the game, and after initial use the participants were overall positive about the format, content and objectives, including validation of emotions and recognition. The participants had suggestions for improved engagement and feasibility. Conclusion: The game was found to be culturally applicable, desirable and acceptable, although Norwegian translation is necessary for further evaluation. Recommendations to enhance engagement were provided, including suggestions to play the game with parents or in a group. Innovation: This initial assessment of the serious game Broodles in a non-Dutch setting shows promise for an innovative way of supporting siblings of children with disabilities.

Summary: Temperature is thought to be a key factor influencing global species richness patterns. We investigate the link between temperature and diversification in the butterfly family Pieridae by combining next generation DNA sequences and published molecular data with fine-grained distribution data. We sampled nearly 600 pierid butterfly species to infer the most comprehensive molecular phylogeny of the family and curated a distribution dataset of more than 800,000 occurrences. We found strong evidence that species in environments with more stable daily temperatures or cooler maximum temperatures in the warm seasons have higher speciation rates. Furthermore, speciation and extinction rates decreased in tandem with global temperatures through geological time, resulting in a constant net diversification.

This study addresses the synthesis, characterization, and evaluation of L-Cysteine (L-Cys) molecules anchored on superparamagnetic iron oxide nanoparticles (SPIONs), mainly magnetite (Fe3O4), for potential drug delivery applications. Fe3O4 nanoparticles are obtained via co-precipitation and functionalized with L-Cys to improve biocompatibility and antioxidant activity. To optimize the functionalization process, the dimerization of cysteine to cystine is investigated by varying the reaction time and mass proportions. The samples are characterized by powder X-ray diffraction (PXRD), Fourier transform infrared (FTIR) and Raman spectroscopies, transmission electron microscopy (TEM), and magnetic curves. These results confirm that L-Cys molecules are anchored on the nanoparticle surface through their carboxylate groups, with free SH groups present in the dispersed nanoparticles. However, in the solid state, L-Cys dimerization leads to a cystine crystal structure, resulting in no free SH groups. The nanoparticles have a magnetite structure with an average crystallite size of (8.7±0.8) nm and superparamagnetic behavior. In vitro biological assays show the antioxidant effect of L-Cysteine on the surface of the nanoparticles.

Summary: Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of SARS-CoV-2 infection. It remains unclear how MIS-C phenotypes vary across SARS-CoV-2 variants. We aimed to investigate clinical characteristics and outcomes of MIS-C across SARS-CoV-2 eras. Methods: We performed a multicentre observational retrospective study including seven paediatric hospitals in four countries (France, Spain, U.K., and U.S.). All consecutive confirmed patients with MIS-C hospitalised between February 1st, 2020, and May 31st, 2022, were included. Electronic Health Records (EHR) data were used to calculate pooled risk differences (RD) and effect sizes (ES) at site level, using Alpha as reference. Meta-analysis was used to pool data across sites. Findings: Of 598 patients with MIS-C (61% male, 39% female; mean age 9.7 years [SD 4.5]), 383 (64%) were admitted in the Alpha era, 111 (19%) in the Delta era, and 104 (17%) in the Omicron era. Compared with patients admitted in the Alpha era, those admitted in the Delta era were younger (ES −1.18 years [95% CI −2.05, −0.32]), had fewer respiratory symptoms (RD −0.15 [95% CI −0.33, −0.04]), less frequent non-cardiogenic shock or systemic inflammatory response syndrome (SIRS) (RD −0.35 [95% CI −0.64, −0.07]), lower lymphocyte count (ES −0.16 × 109/uL [95% CI −0.30, −0.01]), lower C-reactive protein (ES −28.5 mg/L [95% CI −46.3, −10.7]), and lower troponin (ES −0.14 ng/mL [95% CI −0.26, −0.03]). Patients admitted in the Omicron versus Alpha eras were younger (ES −1.6 years [95% CI −2.5, −0.8]), had less frequent SIRS (RD −0.18 [95% CI −0.30, −0.05]), lower lymphocyte count (ES −0.39 × 109/uL [95% CI −0.52, −0.25]), lower troponin (ES −0.16 ng/mL [95% CI −0.30, −0.01]) and less frequently received anticoagulation therapy (RD −0.19 [95% CI −0.37, −0.04]). Length of hospitalization was shorter in the Delta versus Alpha eras (−1.3 days [95% CI −2.3, −0.4]). Interpretation: Our study suggested that MIS-C clinical phenotypes varied across SARS-CoV-2 eras, with patients in Delta and Omicron eras being younger and less sick. EHR data can be effectively leveraged to identify rare complications of pandemic diseases and their variation over time. Funding: None.

Summary: Background: Characterizing Post-Acute Sequelae of COVID (SARS-CoV-2 Infection), or PASC has been challenging due to the multitude of sub-phenotypes, temporal attributes, and definitions. Scalable characterization of PASC sub-phenotypes can enhance screening capacities, disease management, and treatment planning. Methods: We conducted a retrospective multi-centre observational cohort study, leveraging longitudinal electronic health record (EHR) data of 30,422 patients from three healthcare systems in the Consortium for the Clinical Characterization of COVID-19 by EHR (4CE). From the total cohort, we applied a deductive approach on 12,424 individuals with follow-up data and developed a distributed representation learning process for providing augmented definitions for PASC sub-phenotypes. Findings: Our framework characterized seven PASC sub-phenotypes. We estimated that on average 15.7% of the hospitalized COVID-19 patients were likely to suffer from at least one PASC symptom and almost 5.98%, on average, had multiple symptoms. Joint pain and dyspnea had the highest prevalence, with an average prevalence of 5.45% and 4.53%, respectively. Interpretation: We provided a scalable framework to every participating healthcare system for estimating PASC sub-phenotypes prevalence and temporal attributes, thus developing a unified model that characterizes augmented sub-phenotypes across the different systems. Funding: Authors are supported by National Institute of Allergy and Infectious Diseases, National Institute on Aging, National Center for Advancing Translational Sciences, National Medical Research Council, National Institute of Neurological Disorders and Stroke, European Union, National Institutes of Health, National Center for Advancing Translational Sciences.

Summary: Background: While acute kidney injury (AKI) is a common complication in COVID-19, data on post-AKI kidney function recovery and the clinical factors associated with poor kidney function recovery is lacking. Methods: A retrospective multi-centre observational cohort study comprising 12,891 hospitalized patients aged 18 years or older with a diagnosis of SARS-CoV-2 infection confirmed by polymerase chain reaction from 1 January 2020 to 10 September 2020, and with at least one serum creatinine value 1–365 days prior to admission. Mortality and serum creatinine values were obtained up to 10 September 2021. Findings: Advanced age (HR 2.77, 95%CI 2.53–3.04, p

Ultraviolet (UV) induced biofluorescence is being discovered with increasing frequency across the tree of life. However, there is not yet a standardized, low-cost, photographic methodology used to document, quantify, and minimize sources of bias that often accompany reports made by researchers new to fluorescence imaging. Here, a technique is described to create accurate photographs of biofluorescent specimens as well as how to use these images to quantify fluorescence via color quantization, using open-source code that utilizes K-means clusters within the International Commission on Illumination L*a*b* (CIELAB) color space. The complexity of photographing different excitation and emission wavelengths and methods to reduce bias from illumination source and/or camera color sensitivity (e.g., white balance) without the use of modified equipment is also addressed. This technique was applied to preserved southern flying squirrel (Glaucomys volans) specimens to quantify the color shift between illumination under visible and UV light and analyze variation among specimens. This relatively simple methodology can be adapted to future studies across a range of fluorescent wavelengths and project goals, and assist future research in which unbiased photographs and analyses are key to understanding the physiological and ecological role of biofluorescence.

“Green space” effects on health have been amply demonstrated, but whether specific features of green space exert differential effects remains unknown. Driven by developmental psychology theory highlighting the importance of play for young children, we investigated the association between parks with playgrounds, as a subtype of “green space”, and young child mental health. After adjusting for individual race, sex, income, and cumulative risk as well as neighborhood disadvantage, we find that children (N ​= ​95) living near parks with playgrounds have better mental health than those near parks without playgrounds (b ​= ​−1.22 (95% CI: −3.82–1.38, p ​= ​0.36) Child Behavior Checklist scale). While not statistically significant, the observed difference, which is equivalent to 11% of the baseline mean score, is meaningful. Our results, while only suggestive, indicate that moving beyond “green space” to investigate developmentally-specific features may be worthwhile.

BACKGROUND: Telemedicine uses technology to deliver medical care remotely and has been shown to provide similar patient satisfaction and care outcomes compared with in-person visits. OBJECTIVE: This study aimed to assess the gynecologic oncology patient telehealth experience. STUDY DESIGN: All patients receiving telehealth care between March 23, 2020, to May 14, 2020, from a single institution's gynecologic oncology division were offered postvisit surveys to assess satisfaction. Basic demographic and clinical data were collected and analyzed with descriptive statistics. Patient zip code data were correlated with Community Need Index scores and visualized using heat maps. RESULTS: Of 286 telehealth visits, 112 postvisit surveys (39.2%) were collected. Survey responses demonstrated high patient satisfaction with responders agreeing that privacy was respected (97.3%), diagnosis and treatment options were adequately explained (92%), they could easily ask questions (97.3%), and they established a good rapport with their provider (96.4%). Additional benefits included reduced travel (92.9%), time (83.0%), cost (67.9%), and family interruption (57.1%). Among 11 patients receiving treatment on a clinical trial, 10 (90.9%) were able to continue on trial without disruption. Most responders (87.5%) preferred future visits to occur via telehealth or a mixture of telehealth and in-person visits. No difference in satisfaction was found among patients residing in zip codes associated with higher Community Need Index scores or increased distance from the institution. CONCLUSION: The use of telemedicine in providing gynecologic oncology care was associated with high patient satisfaction and had the benefits of reduced time, cost, travel, and interruption to family time.

Despite all knowledge acquired regarding the mutational profile of pediatric myelodysplastic syndrome (MDS), the somatic genomic landscape underlying that disease remains unclear. We evaluated the presence of somatic variants in 37 genes related to myeloid malignancies through targeted NGS in 20 Brazilian patients with refractory cytopenia of childhood (RCC). Only 15% (3/20) of patients showed at least one somatic driver mutation – all in genes coding to regulators of cell signaling (TP53 and CBLB) or epigenetics (ASXL1 and DNMT3A). Interestingly, those variants were identified in patients with no detected clonal chromosomal abnormalities.

Different types of matrices can perform different disturbance regimes over remnant forests, which can ultimately affect plant diversity. To address these issues, we studied 60 plots in forest remnants embedded within sugarcane plantations and pasturelands in the Atlantic Forest of Southeastern Brazil. Our objectives were to evaluate general patterns of plant diversity and to assess the influence of landscape structure and dynamics on plant richness and diversity. We recorded 297 species in two strata. (DBH superior stratum ≥ 4.8 cm > inferior stratum). Overall, diversity of the inferior stratum was higher in pastureland forest remnants than in sugarcane matrices. In the superior stratum, time since abandonment represented a greater influence. Considering the partition of diversity, more than 40% of total diversity was due to the alpha component alone in all cases, but it was significantly lower than expected. Beta components among forest remnants, landscapes and matrices were higher than expected for both strata, whether together or separately. Habitat heterogeneity showed a higher contribution to the total floristic diversity, but among remnants this contribution was even more significant. Forest remnants in pasturelands had a more dynamic land use history and parameters of landscape dynamics were more related to plant diversity. For remnants in the sugarcane matrices, species richness and composition were explained by landscape structure. Our results highlight that there is an important plant community diffused in the forest remnants of human-modified landscapes. Therefore, conserving the majority of remnants and restoring degraded ones must be a key conservation strategy.

Introduction: In Kampala, Uganda, there is a strong cultural practice for patients to have designated caregivers for the duration of hospitalization. At the same time, nursing support is limited. This quality improvement project aimed to standardize caregiver and nursing perioperative care on the gynecologic oncology wards at the Uganda Cancer Institute and Mulago Specialised Women and Neonatal Hospital. Methods: We developed, implemented, and evaluated a multidisciplinary intervention involving standardization of nursing care, patient education, and family member integration from October 2019 – July 2020. Data were abstracted from medical records and patient interviews pertaining to the following outcomes: 1) pain control; 2) post-operative surgical site infections, urinary tract infections, and pneumonia; 3) nursing documentation of medication administration, pain quality, and vital sign assessments, and 4) patient and caregiver education. Descriptive statistics, Fisher’s exact test, and independent samples t-test were applied. Results: Data were collected from 25 patients undergoing major gynecologic procedures. Pre- (N = 14) and post- (N = 11) intervention comparison demonstrated significant increases in preoperative patient education (0% to 80%, p = 0.001) and utilization of a comprehensive postoperative order form (0% to 45.5%, p = 0.009). Increased frequency in nursing documentation of patient checks (3 to 8, p = 0.266) and intraoperative antibiotic administration (9 to 10, p = 0.180) in patient charts did not reach significance. There was no change in infection rate, pain score utilization, caregiver documentation, or preoperative medication acquisition. Conclusion: Our findings suggest that patient- and family-centered perioperative care can be improved through standardization of nursing care, improved education, and integration of caregivers in a nursing-limited setting.

Background: Chagas disease (caused by Trypanosoma cruzi infection) evolves to chronic chagasic cardiomyopathy (CCC) affecting 1.8 million people worldwide. This is the first randomized, placebo-controlled, double-blinded, clinical trial designed to estimate efficacy and safety of selenium (Se) treatment in CCC. Methods: 66 patients with CCC stages B1 (left ventricular ejection fraction [LVEF] > 45% and no heart failure; n = 54) or B2 (LVEF < 45% and no heart failure; n = 12) were randomly assigned to receive 100 mcg/day sodium selenite (Se, n = 32) or placebo (Pla, n = 34) for one year (study period: May 2014-September 2018). LVEF changes over time and adverse effects were investigated. Trial registration number: NCT00875173 (clinicaltrials.gov). Findings: No significant differences between the two groups were observed for the primary outcome: mean LVEF after 6 (β= +1.1 p = 0.51 for Se vs Pla) and 12 months (β= +2.1; p = 0.23). In a subgroup analysis, statistically significant longitudinal changes were observed for mean LVEF in the stage B2 subgroup (β= +10.1; p = 0.02 for Se [n = 4] vs Pla [n = 8]). Se treatment was safe for CCC patients, and the few adverse effects observed were similarly distributed across the two groups. Interpretation: Se treatment did not improve cardiac function (evaluated from LVEF) in CCC. However, in the subgroup of patients at B2 stage, a potential beneficial influence of Se was observed. Complementary studies are necessary to explore diverse Se dose and/or associations in different CCC stages (B2 and C), as well as in A and B1 stages with longer follow-up. Funding: Brazilian Ministry of Health, Fiocruz, CNPq, FAPERJ.

Background & Aims: Recent evidence has suggested that the intact intestinal epithelial barrier protects our body from a range of immune-mediated diseases. The epithelial layer has an impressive ability to reconstitute and repair upon damage and this process of repair increasingly is seen as a therapeutic target. In vitro models to study this process in primary intestinal cells are lacking. Methods: We established and characterized an in vitro model of intestinal damage and repair by applying γ-radiation on small-intestinal organoids. We then used this model to identify novel regulators of intestinal regeneration. Results: We identified hepatocyte nuclear factor 4α (HNF4α) as a pivotal upstream regulator of the intestinal regenerative response. Organoids lacking Hnf4a were not able to propagate in vitro. Importantly, intestinal Hnf4a knock-out mice showed impaired regeneration after whole-body irradiation, confirming intestinal organoids as a valuable alternative to in vivo studies. Conclusions: In conclusion, we established and validated an in vitro damage–repair model and identified HNF4α as a crucial regulator of intestinal regeneration. Transcript profiling: GSE141515 and GSE141518.

Purpose: To present the surgical treatment of a full thickness macular hole (MH) caused by a vitreomacular traction (VMT) on top of an adjacent subfoveal pigment epithelial detachment (PED) in age-related macular degeneration (AMD). Observation: A 77-year-old female with a subfoveal PED receiving consecutive intravitreal injections noticed a sudden decreased visual acuity (VA) due to the development an occult MH in her right eye after 19 repeated intravitreal anti vascular endothelial growth factor (VEGF)-injections. Her initial VA declined from 20/50 to 20/400. The firm VMT induced a rupture of the multi-layered retina and may progress to an RPE-tear or possible to a subretinal haemorrhage. We discussed with the patient the risks of the natural progression and explained possible treatment options: We continued her anti-VEGF combined with air bubble injections to induce a posterior vitreous detachment, to stabilise the retinal architecture, reduce the subretinal fluid and avoid possible intraoperative bleeding. As injections did release the VMT, vitrectomy released the posterior vitreous from the optic nerve and trimmed it towards the central retina. Peeling with brilliant blue removed the internal limiting membrane without any signs of bleeding, rupture of the PED or enlargement of the MH, prior to the installation of 10% SF6 gas. The postoperative optical coherence tomography (OCT) on day 5 confirmed a closed MH, while the size, shape and pattern of the PED remained unchanged. Her VA increased from 20/400 to 20/50 (equal to her previous VA prior to the MH-formation). To avoid a potential progression of the PED, we maintained her retreatment intervals at 5 weeks for the next 6 months. A literature review presents similar intraoperative approaches and postoperative outcomes in 8 out of the 9 published cases. Conclusions and importance: VMT can induce an occult MH on top of a PED, causing a significant loss of vision. When gas injections are not successful, surgery may release the traction, restore the retinal architecture, and significantly improve and maintain the VA over a documented long-term observation. The epiretinal procedure should be assisted under regular anti-VEGF injections to maintain the subretinal architecture.

We describe outcomes of patients with suspected placenta percreta treated with placental uterine artery embolization (P-UAE) followed by delayed hysterectomy. This is a prospective case series of subjects from 2005 to 2018 with suspected placenta percreta who underwent P-UAE at the time of cesarean delivery followed by delayed hysterectomy. Both scheduled and unscheduled surgical cases were included. Maternal characteristics, surgical approaches, intra- and postoperative outcomes were abstracted from medical records. In total, twenty-two subjects were included. Median (interquartile range, IQR) delivery gestational age was 34.6 (31.9, 35.7) weeks, occurring as scheduled in 17 (77.3%) subjects and unscheduled in 5 (22.7%). Delayed hysterectomy was performed as scheduled in 17 (77.3%) subjects at a median (IQR) 40.5 (38.0, 44.0) days after delivery, and 5 (22.7%) subjects had a hysterectomy prior to scheduled date, median (IQR) 27.0 (17.0, 35.0) days after delivery. Indications for the 5 unscheduled hysterectomies included bleeding (n = 3) and suspected endometritis (n = 2). Three subjects (13.6%) received a blood transfusion (1, 3, 3 units) during delivery, and 7 (31.8%) were transfused during delayed hysterectomy (median [IQR] 2 [1,3] units). Three (13.6%) subjects had bladder resection at the time of hysterectomy; 1 (4.5%) had an unintentional cystotomy and 1 (4.5%) had a ureteral injury. P-UAE followed by delayed hysterectomy appears to be a safe and feasible, although appropriate patient selection and close surveillance are imperative, as 22.7% of patients underwent unscheduled hysterectomy.

Background: Maternal Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination provides antibody transfer to newborn infants and may affect their antibody response to the primary vaccination series. This study aimed to assess the effect of Tdap vaccination during pregnancy on infant antibody response to the whole cell pertussis (DTwP) primary series. Methods: Plasma from 318 pregnant women (243 Tdap-vaccinated and 75 unvaccinated) and their infants (cord blood) was collected at delivery; infant blood was again collected at 2 and 7 months, before and after their primary DTwP series. Anti-pertussis toxin (PT), pertactin (PRN), filamentous hemagglutinin (FHA), fimbriae 2/3 (FIM) and adenylate cyclase toxin (ACT) IgG antibodies were quantified by a microsphere-based multiplex antibody capture assay and anti-PT neutralizing antibodies by the Real Time Cell analysis system. Results: Infant geometric mean concentrations (GMCs) of IgG anti-Tdap antigens were significantly higher (p

The presence of small terrestrial mammals along the commercial cycle of Eucalyptus plantations indicates that silvicultural landscapes can be considered as their habitat. In the present study we evaluated the temporal variation of small terrestrial mammals for more than 10 generations during the first commercial cycle of Eucalyptus in Southeast Brazil. During this period we carried out forty-four monthly campaigns, totaling 10,560 bucket.nights in pitfall traps. Thirteen species (four marsupials and nine rodents) were collected in the Eucalyptus plantations, seven of which (Akodon montensis, Calomys tener, Cryptonanus agricolai, Gracilinanus microtarsus, Necromys lasiurus, Oligoryzomys flavescens, and Oligoryzomys nigripes) persisted for the entire study period. In general, they have an explosive population growth during the first two years of collection followed by a decline in all environments, and an apparent regrowth trend in the fourth year for some species with a trend in dominant species from Cerrado to forest dwellers. Marsupials exhibited a similar trend, but slower and later. The spatio-temporal patterns of variation detected in this study strongly suggest that for most of the remaining species of small rodents and marsupials, silvicultural landscapes have distinct habitats including the Eucalyptus plantations. This means that they should be evaluated in terms of its habitat quality not only its permeability. The perception of the Eucalyptus plantations as habitat should stimulate the development of wildlife-friendly management techniques, which improve their carrying capacity, food web complexity and biological diversity without compromising their primeval mission of biological production.

Objective: To assess the efficacy of the Baby's Mouth early dental care prevention and promotion program in preventing oral diseases (caries, gingivitis, or malocclusions) in children attended since 2010. Methods: This was a cross-sectional and cohort study that assessed 252 children between 36 and 60 months of age in both sexes. The children were divided into three groups: G1: effective participants of the program from birth; G2: children who have stopped participating for more than 24 months, and G3: children who have never attended a prevention program. The evaluation was carried out in two stages: first, an interview with the mothers and, afterwards, a clinical children examination to assess the presence of caries, gingivitis, and malocclusion. The chi-squared test was used for statistical analysis between groups (p

This study reports a new Trichodinidae, Trichodina bellottii n. sp., parasitizing the pearly fish Austrolebias bellottii from Buenos Aires, Argentina. Its small subunit ribosomal ribonucleic acid (SSU rDNA) was sequenced for the first time. Based on the results from morphological identification, SSU rDNA sequencing, and Elliptical Fourier analysis, the new species was identified and compared with similar species. Phylogenetic analysis revealed that the genetic distances among the new species and similar species reached interspecific levels, furthermore, the phylogenetic study also validated the identification of T. bellottii n. sp. and its placement in the genus Trichodina. To be able to quantitatively describe the differences in shapes with similar species, this study used the elliptic Fourier analysis by first time in this genus. Keywords: Trichodinidae, Outlines analysis, Austrolebias bellottii, Fourier analysis

Background: Transversus abdominis plane (TAP) block is useful in reducing post-operative pain in laparoscopic nephrectomy compared to placebo. The purpose of this work is to compare post-operative pain and recovery after TAP block or trocar site infiltration (TSI) in this surgery. Methods: A prospective, single blinded study on patients scheduled for laparoscopic nephrectomy. Patients were assigned to two groups: TSI Group: trocar site infiltration at the end of surgery; TAP Group: unilateral ultrasound-guided TAP block after induction. Sevoflurane and remifentanil, in a target controlled infusion mode, were used for maintenance of general anesthesia. Before the end of surgery paracetamol, tramadol and morphine were administered. Visual analogue scale (VAS 0–100 mm) at rest and with cough was applied in three moments: in recovery room (T1 at admission and T2 before discharge) and 24 h after surgery (T3). Pain scores with incentive spirometer were also evaluated at T3. In recovery, morphine was administered as a rescue drug whenever VAS > 30 mm. Time to oral intake, chair sitting, ambulation and length of hospital stay were evaluated 24 h after surgery. Statistical analysis: Student's t-test and Chi-square test, and linear regression models. A p-value 0.05). VAS at rest (TAP vs. TSI groups) was: T1 = 33 ± 29 vs. 39 ± 32, T2 = 10 ± 9 vs. 17 ± 18 and T3 = 7 ± 12 vs. 10 ± 18. VAS with cough (TAP vs. TSI groups) was: T1 = 51 ± 34 vs. 45 ± 32, T2 = 24 ± 24 vs. 33 ± 23 and T3 = 20 ± 23 vs. 23 ± 23. VAS with incentive spirometer (TAP vs. TSI groups) was: T3 = 21 ± 27 vs. 21 ± 25. Intraoperative remifentanil consumption was similar between TAP (0.16 ± 0.07 mcg.kg−1.min−1) and TSI (0.18 ± 0.9 mcg.kg−1.min−1) groups. There were no differences in opioid consumption between TAP (4.4 ± 3.49 mg) and TSI (6.87 ± 4.83 mg) groups during recovery. Functional recovery parameters were not statistically different between groups. Conclusions: Multimodal analgesia with TAP block did not show a significant clinical benefit compared with trocar site infiltration in laparoscopic nephrectomies. Resumo: Justificativa: O bloqueio do plano transverso abdominal (TAP) é útil para reduzir a dor no pós-operatório de nefrectomia laparoscópica comparado ao placebo. O objetivo deste estudo foi comparar a dor no pós-operatório e a recuperação após bloqueio TAP ou infiltração do sítio do trocarte (TSI) nesse tipo de cirurgia. Métodos: Estudo prospectivo e cego com pacientes agendados para nefrectomia laparoscópica. Os pacientes foram divididos em dois grupos: Grupo TSI: infiltração do sítio do trocarte ao final da cirurgia; Grupo TAP: bloqueio TAP unilateral guiado por ultrassom após a indução. Sevoflurano e remifentanil administrado em perfusão alvo-controlada foram usados para a manutenção da anestesia geral. Paracetamol, tramadol e morfina foram administrados antes do fim da cirurgia. Escala analógica visual (VAS 0–100 mm), para avaliar a dor em repouso e durante a tosse, foi aplicada em três momentos: na sala de recuperação [na admissão (T1) e antes da alta (T2)] e 24 horas após a cirurgia (T3). Os escores de dor com espirômetro de incentivo também foram avaliados em T3. Durante a recuperação, morfina foi administrada como medicamento de resgate, sempre que VAS >30 mm. Os tempos até a ingestão oral, sentar em cadeira, deambulação e de permanência hospitalar foram avaliados 24 horas após a cirurgia. Análise estatística: teste-t de Student, teste do qui-quadrado e modelos de regressão linear. Um valor de p 0,05). Os escores VAS em repouso (TAP vs. TSI) foram: T1 = 33 ± 29 vs. 39 ± 32; T2 = 10 ± 9 vs. 17 ± 18 e T3 = 7 ± 12 vs. 10 ± 18. Os escores VAS durante a tosse (TAP vs. TSI) foram: T1 = 51 ± 34 vs. 45 ± 32; T2 = 24 ± 24 vs. 33 ± 23 e T3 = 20 ± 23 vs. 23 ± 23. Os escores VAS com espirômetro de incentivo (TAP vs. TSI) foram: T3 = 21 ± 27 vs. 21 ± 25. O consumo de remifentanil no intraoperatório foi semelhante entre os grupos TAP (0,16 ± 0,07 mcg.kg−1.min−1) e TSI (0,18 ± 0,9 mcg.kg−1.min−1). Não houve diferença no consumo de opioides entre os grupos TAP (4,4 ± 3,49 mg) e TSI (6,87 ± 4,83 mg) durante a recuperação. Os parâmetros funcionais de recuperação não foram estatisticamente diferentes entre os grupos. Conclusões: A analgesia multimodal com bloqueio TAP não mostrou benefício clínico significativo comparado à infiltração do sítio do trocarte em nefrectomia laparoscópica. Keywords: Multimodal analgesia, Laparoscopic nephrectomy, Ultrasound Transversus abdominis plane block, Palavras-chave: Analgesia multimodal, Nefrectomia laparoscópica, Bloqueio TAP guiado por ultrassom

Duchenne muscular dystrophy (DMD) is a lethal, X-linked, muscle-wasting disorder caused by mutations in the large, 2.4-Mb dystrophin gene. The majority of DMD-causing mutations are sporadic, multi-exon, frameshifting deletions, with the potential for variable immunological tolerance to the dystrophin protein from patient to patient. While systemic gene therapy holds promise in the treatment of DMD, immune responses to vectors and transgenes must first be rigorously evaluated in informative preclinical models to ensure patient safety. A widely used canine model for DMD, golden retriever muscular dystrophy, expresses detectable amounts of near full-length dystrophin due to alternative splicing around an intronic point mutation, thereby confounding the interpretation of immune responses to dystrophin-derived gene therapies. Here we characterize a naturally occurring deletion in a dystrophin-null canine, the German shorthaired pointer. The deletion spans 5.6 Mb of the X chromosome and encompasses all coding exons of the DMD and TMEM47 genes. The sequences surrounding the deletion breakpoints are virtually identical, suggesting that the deletion occurred through a homologous recombination event. Interestingly, the deletion breakpoints are within loci that are syntenically conserved among mammals, yet the high homology among this subset of ferritin-like loci is unique to the canine genome, suggesting lineage-specific concerted evolution of these atypical sequence elements.

Neisseria meningitidis is a leading bacterial cause of sepsis and meningitis globally with dynamic strain distribution over time. Beginning with an epidemic among Hajj pilgrims in 2000, serogroup W (W) sequence type (ST) 11 emerged as a leading cause of epidemic meningitis in the African ‘meningitis belt’ and endemic cases in South America, Europe, Middle East and China. Previous genotyping studies were unable to reliably discriminate sporadic W ST-11 strains in circulation since 1970 from the Hajj outbreak strain (Hajj clone). It is also unclear what proportion of more recent W ST-11 disease clusters are caused by direct descendants of the Hajj clone. Whole genome sequences of 270 meningococcal strains isolated from patients with invasive meningococcal disease globally from 1970 to 2013 were compared using whole genome phylogenetic and major antigen-encoding gene sequence analyses. We found that all W ST-11 strains were descendants of an ancestral strain that had undergone unique capsular switching events. The Hajj clone and its descendants were distinct from other W ST-11 strains in that they shared a common antigen gene profile and had undergone recombination involving virulence genes encoding factor H binding protein, nitric oxide reductase, and nitrite reductase. These data demonstrate that recent acquisition of a distinct antigen-encoding gene profile and variations in meningococcal virulence genes was associated with the emergence of the Hajj clone. Importantly, W ST-11 strains unrelated to the Hajj outbreak contribute a significant proportion of W ST-11 cases globally. This study helps illuminate genomic factors associated with meningococcal strain emergence and evolution.

Objective: To determine the rate and performance of sentinel lymph node (SLN) mapping among women with high-risk endometrial cancers. Methods: Patients diagnosed between 2012 and 2015 with uterine cancer of grade 3 endometrioid, clear cell, serous or carcinosarcoma histology and who underwent SLN mapping prior to full pelvic lymph node dissection were included. Subjects underwent methylene blue or ICG injection for laparoscopic (N = 16) or robotic-assisted laparoscopic (N = 20) staging. Outcomes included SLN mapping rates, SLN and non-SLN positive rates, false negative SLN algorithm rate, and the negative predictive value (NPV) of the SLN algorithm. Fisher's exact test was used to compare mapping and node positivity rates. Results: 9/36 (25%) patients with high-risk uterine cancer had at least one metastatic lymph node identified. Successful mapping occurred in 30/36 (83%) patients. SLN mapped to pelvic nodes bilaterally in 20 (56%), unilaterally in 9 (25%), and aortic nodes only in 1 (3%). Malignancy was identified in 14/95 (15%) of all sentinel nodes and 12/775 (1.5%) of all non-sentinel nodes (p

This study presents a 2014 high-resolution spatially disaggregated emission inventory (0.025° × 0.025° horizontal resolution), of the main activities in the energy sector in Argentina. The sub-sectors considered are public generation of electricity, oil refineries, cement production, transport (maritime, air, rail and road), residential and commercial. The following pollutants were included: greenhouse gases (CO2, CH4, N2O), ozone precursors (CO, NOx, VOC) and other specific air quality indicators such as SO2, PM10, and PM2.5. This work could contribute to a better geographical allocation of the pollutant sources through census based population maps. Considering the sources of greenhouse gas emissions, the total amount is 144 Tg CO2eq, from which the transportation sector emits 57.8 Tg (40%); followed by electricity generation, with 40.9 Tg (28%); residential + commercial, with 31.24 Tg (22%); and cement and refinery production, with 14.3 Tg (10%). This inventory shows that 49% of the total emissions occur in rural areas: 31% in rural areas of medium population density, 13% in intermediate urban areas and 7% in densely populated urban areas. However, if emissions are analyzed by extension (per square km), the largest impact is observed in medium and densely populated urban areas, reaching more than 20.3 Gg per square km of greenhouse gases, 297 Mg/km2 of ozone precursors gases and 11.5 Mg/km2 of other air quality emissions. A comparison with the EDGAR global emission database shows that, although the total country emissions are similar for several sub sectors and pollutants, its spatial distribution is not applicable to Argentina. The road and residential transport emissions represented by EDGAR result in an overestimation of emissions in rural areas and an underestimation in urban areas, especially in more densely populated areas. EDGAR underestimates 60 Gg of methane emissions from road transport sector and fugitive emissions from refining activities.

O polimorfismo da glicoproteína IIIa de plaquetas está associado a um aumento no risco de doenças arteriais coronarianas. Mulheres com diabetes mellitus tipo 2 apresentam um aumento de cinco vezes no risco para doenças arteriais coronarianas quando comparadas com mulheres não-diabéticas. O objetivo do presente estudo foi verificar a frequência do polimorfismo da glicoproteína IIIa (PlA2) em mulheres com diabetes mellitus tipo 2 e comparar com a frequência descrita na literatura. A análise do polimorfismo PlA2 foi realizada para 62 mulheres com diabetes mellitus tipo 2 através da reação em cadeia da polimerase seguida de análise do polimorfismo de tamanho de fragmento de restrição (PCR-RFLP). As frequências observadas foram 81% para PlA1A1, 18% para PlA1A2 e 1% para PlA2A2. Não houve diferença significativa entre as frequências observadas e as frequências descritas na literatura. Nossos resultados sugerem que a frequência do polimorfismo PlA2 em mulheres com diabetes mellitus tipo 2 é a mesma observada na população em geral.The platelet glycoprotein IIIa polymorphism is associated to an increased risk of coronary heart disease. Type 2 diabetic women present a fivefold higher risk of coronary heart disease compared to non-diabetic women. The aim of this study was to verify the frequency of the glycoprotein IIIa polymorphism (PlA2) in type 2 diabetic women and compare this result with the frequency reported for the general population. The PlA polymorphisms of 62 type 2 diabetic women were determined by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). The resulting frequencies were 81% for PlA1A1, 18% for PlA1A2 and 1% for PlA2A2. There was no significant difference between observed frequencies and the frequencies described in the literature. Our results suggest that the frequency of the glycoprotein IIIa polymorphism, PlA2, in type 2 diabetic women is similar to that observed in general population

T-cell acute lymphoblastic leukemia (T-ALL) is characterized by the presence of differentiation-inhibited pro- and pre-T-cell blasts. The p16INK4a tumor suppressor gene has been shown to be frequently deleted in human T-ALL cases. Deletion of p16INK4a may be associated with poor prognosis and relapse of the disease. Radiation-induced murine T-ALL in C57B1/6 mice shares pathogenetic and molecular characteristics with the human disease. We used the murine disease as a model to study the status of the INK4/ARF gene locus and to examine the effect of p16INK4a-re-expression in T-ALL cells on their leukemic potential in vivo. In 9 of 17 radiation-induced murine T-ALL cell lines, the p16INK4a protein was not expressed as determined by immunoblotting. Southern blot analysis revealed homozygous deletions of the p16INK4a gene locus in three of the nine lines, along with the genes encoding p15INK4b and p19ARF. Transduction of p16INK4a-negative T-ALL lines with retrovirus encoding p16INK4a significantly inhibited their in vitro proliferation by inducing G1-arrest. Importantly, re-expression of p16INK4a in p16INK4a-negative T-ALL cells obliterated the induction of lethal disseminated leukemia in syngeneic mice. This is the first demonstration that re-establishment of p16INK4a expression is critical for in vivo growth regulation of T-ALL cells.