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Background: –A study to assess lead exposure of traveller children aged from 9 months to 18 years old was conducted in Charente-France between 2017 and 2019. Methods: A face-to-face questionnaire was administered to each participating family (N = 78). Blood samples were collected, and in case of lead poisoning, an environmental survey of soil, dust and water samples was also performed. Results: –Among the 100 children, they were 39 girls and 61 boys. Among them, 40 suffered from lead poisoning (Blood Lead Level ≥50 μg/L). Being a boy aged between 11 and 14 years old, and participating in lead exposure at-risk activities were significantly associated with higher mean blood lead level. Conclusion: –The high levels of lead detected advocate the reinforcement of lead poisoning screening for all children in the traveller population.

Objetivo: Describir la técnica quirúrgica, las indicaciones y los resultados iniciales de la osteotomía periacetabular bernesa para tratar la displasia del desarrollo de la cadera. Materiales y Métodos: Entre mayo de 2011 y mayo de 2020, se realizaron 44 osteotomías periacetabulares bernesas en 44 pacientes (35 mujeres, edad promedio 30 años [rango 23-38]). Todos tenían diagnóstico de displasia de cadera sintomática. El ángulo centro-borde promedio fue de 17° (rango 9°-20°) y el índice acetabular promedio, de 18° (rango 15°-20°). En 22 casos, se evaluaron y repararon los hallazgos intrarticulares por artroscopia en el mismo acto quirúrgico. Se evaluaron la corrección obtenida, la consolidación de la osteotomía y los resultados funcionales al final del seguimiento. Resultados: En 22 pacientes, se detectó hipertrofia y rotura del labrum acetabular asociadas a displasia de cadera. Diez pacientes tenían quistes paralabrales. El ángulo centro-borde promedio posoperatorio fue de 32° (rango 27°-35°) y el índice acetabular, de 6° (rango 4°-9°). El tiempo quirúrgico para la osteotomía periacetabular bernesa fue de 130 min, cuando se sumó un procedimiento artroscópico, el tiempo fue de 148 minutos. Conclusiones: La osteotomía periacetabular bernesa es técnicamente demandante, pero logra resultados predecibles en pacientes con integridad del cartílago articular y deformidades corregibles. La artroscopia antes de la osteotomía permite evaluar las condiciones del cartílago, diagnosticar y tratar lesiones intrarticulares asociadas con esta enfermedad y decidir si es necesaria la corrección del déficit de cobertura.

Traceability was introduced about twenty years ago to face the worldwide spread of food safety crises. Traceability data flow associated with each lot of food products during any production and/or delivery phases can also be used to guarantee product authenticity. For this purpose, it is necessary to protect the data from cyber intrusions and, at the same time, to guarantee the integrity of the bond between the physical product and the data. Price grading related to quality perceivable or credence attributes attracts criminals to attempt item substitution fraud. Improved track and trace technologies supported by artificial intelligence (AI) could highly enhance systems’ capability to detect authenticity violations by product substitution. This paper proposes an innovative method based on AI, to reinforce traceability systems in detecting possible counterfeiting by product substitution. It is an item-based mass balance method that analyses the congruity of the traceability data flows not by using explicit (even stochastic) rules but by exploiting the learning capabilities of a neural network. The system can then detect suspect information in a traceability data flow, alerting a possible profit-driven crime. The AI-based method was applied to a pork slaughtering and meat cutting chain case study.

Pediatric high-grade gliomas (pHGGs) are the leading cause of cancer-related deaths in children in the USA. Sixteen percent of hemispheric pediatric and young adult HGGs encode Gly34Arg/Val substitutions in the histone H3.3 (H3.3-G34R/V). The mechanisms by which H3.3-G34R/V drive malignancy and therapeutic resistance in pHGGs remain unknown. Using a syngeneic, genetically engineered mouse model (GEMM) and human pHGG cells encoding H3.3-G34R, we demonstrate that this mutation led to the downregulation of DNA repair pathways. This resulted in enhanced susceptibility to DNA damage and inhibition of the DNA damage response (DDR). We demonstrate that genetic instability resulting from improper DNA repair in G34R-mutant pHGG led to the accumulation of extrachromosomal DNA, which activated the cyclic GMP–AMP synthase/stimulator of IFN genes (cGAS/STING) pathway, inducing the release of immune-stimulatory cytokines. We treated H3.3-G34R pHGG–bearing mice with a combination of radiotherapy (RT) and DNA damage response inhibitors (DDRi) (i.e., the blood-brain barrier–permeable PARP inhibitor pamiparib and the cell-cycle checkpoint CHK1/2 inhibitor AZD7762), and these combinations resulted in long-term survival for approximately 50% of the mice. Moreover, the addition of a STING agonist (diABZl) enhanced the therapeutic efficacy of these treatments. Long-term survivors developed immunological memory, preventing pHGG growth upon rechallenge. These results demonstrate that DDRi and STING agonists in combination with RT induced immune-mediated therapeutic efficacy in G34-mutant pHGG.

Background: Blastocystis has been associated with various symptoms of the gastrointestinal tract. We aimed to investigate the prevalence of Blastocystis in children with celiac disease (CeD) or functional abdominal pain (FAP) and to evaluate its subtypes (STs) with respect to demographic, socioeconomic and epidemiological factors. Methods: Overall, 161 fecal samples were collected from healthy children and patients with FAP or CeD in Hitit University Erol Olçok Research and Training Hospital, Corum, Turkey between 2016-2018. Samples were examined using both native-Lugol (NL) and trichrome-stained (TS) smears, and further analyses by PCR and Sanger sequencing were performed. A standard questionnaire was applied to obtain demographic, socioeconomic, epidemiological data. Results: Blastocystis was found in 10.6% of the total study population. Neither bacteria nor any other parasites were found, except for one Giardia (0.6%) in the CeD group. The presence/absence of the parasite was not found to be associated with demographic, socioeconomic and epidemiological factors. Blastocysis was detected in 11.5% (6/52) of the CeD, 7.7% (4/52) of the FAP, and 12.3% (7/57) of the healthy group. Diagnostic methods were similar in terms of Blastocystis detection (P= 0.671), and there was fair agreement between the NL, TS and PCR (Fleiss' Kappa=0.847, P=0.001). ST2 (42.8%) and ST3 (35.7%) were the predominant STs followed by ST1 (21.4%). Conclusion: We observed no difference between study groups in terms of Blastocystis prevalence. ST1, ST2 and ST3 subtypes were detected. Blastocystis prevalence and STs were not related to any of the demographic, socioeconomic and epidemiological factors.

Introducción: El objetivo del estudio fue analizar la supervivencia sin recurrencia de infección en pacientes con reemplazo total de cadera tratados con revisión en dos tiempos, valorando el impacto del cultivo intraoperatorio y la congelación positiva en el reimplante. Materiales y Métodos: Estudio retrospectivo de 96 casos con infección periprotésica crónica, según los criterios de la MusculoSkeletal Infection Society, sometidos a los dos tiempos quirúrgicos en nuestra institución, entre 2008 y 2013. El seguimiento promedio fue 90 meses. La falla séptica se definió sobre la base de un consenso tipo Delphi modificado. La supervivencia sin falla séptica se definió sobre la base del estimador de Kaplan-Meier. Se compararon los resultados de supervivencia en función del cultivo intraoperatorio y de los estudios de anatomía patológica por congelación mediante la prueba del orden logarítmico. Resultados: La supervivencia sin falla séptica fue del 82,65% a los 2 años (IC95% 73,25-88,99%), 80,40% a los 5 años (IC95% 70,70-87,17%) y 77,32% a 6-10 años (IC95% 66,90-84,33%). Hubo significativamente más fallas en los pacientes con un cultivo positivo en el reimplante que en aquellos con un cultivo negativo (prueba del orden logarítmico, p = 0,0208), y en quienes tuvieron un estudio anatomopatológico por congelación positivo en el reimplante que en aquellos con un resultado negativo (prueba del orden logarítmico, p = 0,0154). Conclusiones: Los reimplantes sin recurrencias infecciosas por, al menos, 6 años tuvieron un riesgo de falla séptica muy bajo. Cuando se detectó un cultivo o una congelación positivos, la falla séptica fue significativamente mayor.

Las lesiones del labrum de la cadera con sustancia insuficiente se pueden tratar con técnicas de aumento, de reconstrucción o con trasplante de tejidos. Si el remanente labral es muy escaso, las opciones reconstructivas serían las más adecuadas. Se presenta el caso de una paciente de 40 años con dos cirugías artroscópicas previas fallidas por lesión labral, que fue sometida a una luxación controlada de cadera, siguiendo la técnica original descrita por Ganz, y a la resección del ligamento redondo de la cabeza femoral para cubrir el defecto del labrum. Según nuestro conocimiento, se trata del primer reporte de reconstrucción labral utilizando el ligamento redondo de la cabeza femoral en nuestro medio. Pese a los resultados poco alentadores en pacientes con cirugías previas, la reconstrucción labral utilizando el ligamento redondo ha mostrado ser una alternativa viable.

Purpose: The present study aimed to compare surgical outcomes and cost analysis of robotic-assisted surgery (RAS) and conventional laparoscopic surgery (CLS) hysterectomy procedures. Materials and Methods: The patients who underwent total robotic hysterectomy or total conventional laparoscopic hysterectomy with or without bilateral salpingo-oophorectomy due to benign gynecological disorders such as uterine fibroid, abnormal uterine bleeding, endometrial hyperplasia, adenomyosis, persistent ovarian cysts, chronic pelvic pain were retrospectively evaluated. Results: A total of 80 women underwent RAS or CLS hysterectomy during the study period. The mean total operative time was 187 ±10 min. in RAS and 133 ±24 min. in CLS groups, respectively. The mean total cost of the RAS hysterectomy group was 17.710 TL, and CLS hysterectomy group was 7000 TL. Conclusion: Both CLS and RAS hysterectomies for benign gynecological indications are safe surgical procedures with negligible complication rates. RAS is a more expensive procedure compared to CLS.

Las fracturas por insuficiencia subcondral son una causa poco frecuente de cadera dolorosa. A diferencia de las fracturas traumáticas agudas, las fracturas por insuficiencia del acetábulo son menos frecuentes que las femorales. Ocurren habitualmente en mujeres posmenopáusicas con comorbilidades. Su diagnóstico inicial suele ser dificultoso y la sospecha clínica es de gran importancia. La resonancia magnética es una herramienta fundamental para detectar este cuadro. Subestimar estas lesiones puede llevar al desarrollo de una artrosis rápidamente progresiva y al reemplazo articular como desenlace. Se presenta el caso de una paciente de 68 años con una fractura por insuficiencia subcondral del acetábulo a quien se le indicó una artroplastia total de cadera no cementada.

The construction industry is essential to the development and economy, but is also the largest generator of construction and demolition waste (CDW). While efforts are made to minimize such generation, the construction industry has been developing applications for it in the form of aggregates to replace the commonly used natural aggregates. However, in structural applications, it is necessary to ensure that the properties of concrete produced with CDW, as recycled aggregates (CDW-concrete), guarantee adequate performance and do not put the structure at risk. For this, one of the alternatives is improving the properties of CDW aggregates through carbonation, a process called carbonate curing or accelerated carbonation. In this sense, this paper aims to investigate the carbonation of CDW aggregates, clarifying how this process occurs, the existing carbonation methods, the main properties that affect this process, and their influence on the properties of recycled aggregates and the CDW-concrete. To this end, the SREE (systematic review for engineering and experiments) method was used to search and analyze scientific manuscripts published without a time limit. The results revealed that the most widely used method for carbonate curing is recommended by Chinese standard GB50082, and highlighted the need for further research to investigate the CDW-concrete, focusing on its eco-friendly potential to capture CO2 from the atmosphere.

El emprendimiento es un vector que ayuda al crecimiento económico de un país, una región, al escalamiento social y la generación de empleo. Sin embargo, no es claro cuáles son las habilidades blandas requeridas para iniciar un emprendimiento en ingeniería. Esta investigación tiene como propósito determinar cuáles son esas habilidades como referencia para mejorar la competitividad en los ingenieros como en los programas de pregrado. Para alcanzar este objetivo, se diseñó y aplicó una encuesta a ingenieros mecánicos egresados de la Universidad de Pamplona. El instrumento con validez y confiabilidad excelente según Alfa de Cronbach, costaba de 4 dimensiones diferentes que valoraban 10 habilidades blandas con 18 indicadores. Las herramientas estadísticas usadas fueron la prueba bilateral de Kolmogórov-Smirnov, mediana, moda, Kruskal-Wallis ANOVA y post hoc de Games-Howell. Se encontró que todas las habilidades blandas investigadas son requeridas en un nivel alto de desarrollo para realizar un emprendimiento en ingeniería. Así mismo, que los ingenieros encuestados demuestran un nivel alto de desarrollo de estas habilidades, de tal forma que la brecha entre aquellas requeridas para realizar un emprendimiento en ingeniería y las desarrolladas, es pequeña, además, se evidencio que la forma más efectiva para incrementar su desarrollo es realizar entrenamientos en áreas administrativas o desarrollo personal. Se encontró también que los ingenieros dedicados a la docencia, o que trabajan en instituciones públicas, tienen menos desarrollado tres de los seis indicadores de emprendimiento. Finalmente se evidenció que la brecha entre las habilidades formadas en el pregrado y las requeridas en el emprendimiento son grandes, y los programas deben incluir en su currículo formaciones vivenciales de habilidades blandas y emprendimiento.

Objective: Coital incontinence is the involuntary leakage of urine during sexual intercourse and is rarely reported in women with urinary incontinence. The aim of this study is to investigate the frequency of coital incontinence and its association with incontinence types. Study Design: All sexually active women with urinary incontinence (diagnosed as self-reported) attending the out-patient gynecology clinic of a regional state hospital were interviewed consecutively between September 2017 and September 2018 about their experience with regards to coital incontinence. The clinical evaluation consisted of medical history, physical examination, and urine analysis. The SPSS 20 program designed for Windows was used for statistical analysis. Results: Twenty-two of the 64 women who participated in the study were diagnosed with coital incontinence and the remaining 42 women were to be compared. 42 women were included in the control group, and 22 women were defined as the study group. The women with coital incontinence had significantly higher stress test positivity than the control group (p = 0.00). No significant differences in the frequency of coital incontinence between incontinence types were found. The chi-square test was applied, and the p-value was >0.05 (p=0.110). So there was no statistically significant relationship between the type of incontinence and the frequency of coital incontinence. Conclusion: Coital incontinence is much more prevalent than expected and therefore patients with symptomatic urinary incontinence should be investigated for the presence of coital incontinence, as this may affect patient approach and treatment.

Abstract Objective: Despite evidence favoring perioperative antibiotic prophylaxis (ABP) use in patients undergoing craniotomy to reduce rates of surgical site infections (SSIs), standardized protocols are lacking. We describe demographic characteristics, risk factors, and ABP choice in patients with craniotomy complicated with SSI. Design: Retrospective case series from January 1, 2017, through December 31, 2020. Setting: Tertiary-care referral center. Patients: Adults who underwent craniotomy and were diagnosed with an SSI. Methods: Logistic regression to estimate odds ratios and 95% confidence intervals to identify factors associated with SSIs. Results: In total, 5,328 patients undergoing craniotomy were identified during the study period; 59 (1.1%) suffered an SSI. Compared with non-SSI cases, patients with SSI had a significantly higher frequency of emergency procedures: 13.5% versus 5.8% (P = .02; odds ratio [OR], 2.52; 95% confidene interval [CI], 1.10–5.06; P = .031). Patients with SSI had a higher rate of a dirty (5.1% vs 0.9%) and lower rate of clean-contaminated (3.3% vs 14.5%) wound class than those without infection (P = .002). Nearly all patients received ABP before craniotomy (98.3% in the SSI group vs 99.6% in the non-SSI group; P = .10). Combination of vancomycin and cefazolin as dual therapy was more prevalent in the group of patients without infection (n = 1,761, 34.1%) than those with SSI (n = 4, 6.8%) (P < .001), associated with decreased odds for SSI (OR, 0.17; 95% CI, 0.005–0.42; P ≤ .001). Conclusions: SSI are frequently seen after an emergent neurosurgical procedure and a dirty wound classification. Combination of prophylactic cefazolin and vancomycin is associated with decreased risk for SSI.

Civil construction is essential for the world economy and the largest generator of construction and demolition waste (CDW), mainly due to a lack of planning, technological control, and restoration execution, among other factors. While efforts are made to minimize this waste generation, one possible application for CDW is its incorporation into Portland cement-based materials as recycled aggregates, in partial or total replacement of natural aggregates. However, for CDW use to be feasible, the structure performance and safety must be assured, and the adherence between concrete and reinforcement bars, in this context, is a fundamental mechanism. With this perspective, this paper aims to investigate the influence of recycled aggregate on steel–concrete bonding. To this end, the SREE (Systematic Review for Engineering and Experiments) method was employed as a novelty, including a methodology quality analysis, to search and analyze relevant scientific articles published in the last ten years. The results revealed that the use of CDW as recycled aggregates in concrete worsens the steel–concrete bonding, and that ribbed steel bar seems to be the best option when employed in RC structures built with CDW-concrete, although the bar diameter and the anchorage length still need further investigations, and that CDW-concrete’s use can significantly contribute to reducing the emission of greenhouse gases and to capturing CO2 from the atmosphere. Therefore, further investigations should focus on the real influence of recycled aggregate type and replacement content, bar diameter, anchorage length, and CDW’s potential to capture CO2.

BackgroundRecently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans.ObjectivesThe authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process to determine the validity of these concerns. Here, we present the results of that examination, review the history of IARC evaluations, and describe how the IARC evaluations are performed.DiscussionWe concluded that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various disciplines and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed.ConclusionsThe IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public's health.

The present article deals with environmental health literacy (EHL) in contaminated sites. The Italian national epidemiological surveillance system of population resident in contaminated sites, including vulnerable subgroups, and the local epidemiological studies and communication initiatives implemented in specific sites are considered. The Italian experience in contaminated sites corroborates the importance of EHL as a key component of community capacity to participate in mitigating environmental health risks. Effective access to evidence-based information on environmental health risk is the basis for improving awareness of local institutional and social actors. The proactive involvement of stakeholders in preventive actions and the adoption of shared practices reflect the progressive increase of their EHL. Bidirectional communication relying on participative approaches, collaborative nationallocal initiatives, and dialogue with the communities is an effective tool for increasing EHL at each site. This enhances the community capacity to use the acquired knowledge in promoting prevention actions. Consideration of socioeconomic fragilities and vulnerable groups in well-designed EHL practices contributes to prevent adverse health effects induced by specific environmental exposures and to promote environmental justice at local level.

Se plantean los pasos a seguir para realizar un mapeo científico sobre un tema de investigación utilizando herramientas que permitan identificar diferentes relaciones y análisis entre artículos, tomando como caso de estudio el tema de enfermedades infecciosas bovinas. La metodología utilizada se basa en seis pasos que van desde la recuperación de información por medio de la revisión sistemática de literatura hasta la visualización de los resultados por medio de la herramienta de análisis de mapas científicos SciMAT, empleando principalmente las palabras clave, el índice H y la ocurrencia de los términos en el texto. Se encuentra como resultado que los estudios sobre enfermedades infecciosas bovinas se han centrado en subtemas como brotes de la enfermedad, tratamientos utilizados, modelos de prevención y análisis de muestras de laboratorio. Por otro lado, se denota que hace falta realizar estudios sobre el uso de herramientas informáticas o el desarrollo de aplicaciones que utilicen técnicas modernas como inteligencia artificial y machine learning como apoyo al análisis, el control y la erradicación de enfermedades infecciosas bovinas.

The aim of the present study was to evaluate the fatigue to cyclic and static resistance of indirect restorations with different preparation designs made either of lithium disilicate (LS) or polymer-infiltrated ceramic network (PICN). Eighty-four (n = 84) molars were chosen, endodontically treated, and prepared with standardized MOD cavities. The molars were randomly divided into 6 study groups (n = 14) taking into account the “preparation design’’ (occlusal veneer with 1.2 mm occlusal thickness; overlay with 1.6 mm occlusal thickness; adhesive crown with 2 mm occlusal thickness) and the “CAD/CAM material’’ (E-max CAD, Ivoclar vivadent; Vita Enamic, Vita). A fatigue test was conducted with a chewing simulator set at 50 N for 1,500,000 cycles. Fracture resistance was assessed using a universal testing machine with a 6 mm diameter steel sphere applied to the specimens at a constant speed of 1 mm/min. A SEM analysis before the fracture test was performed to visually analyze the tooth-restoration margins. A statistical analysis was performed with a two-way ANOVA and a post-hoc pairwise comparison was performed using the Tukey test. The two-way ANOVA test showed that both the preparation design factor (p = 0.0429) and the CAD/CAM material factor (p = 0.0002) had a significant influence on the fracture resistance of the adhesive indirect restorations. The interaction between the two variables did not show any significance (p = 0.8218). The occlusal veneer had a lower fracture resistance than the adhesive crown (p = 0.042) but not lower than the overlay preparation (p = 0.095). LS was more resistant than PICN (p = 0.002). In conclusion, in the case of endodontically treated teeth, overlay preparation seems to be a valid alternative to the traditional full crown preparation, while occlusal veneers should be avoided in restoring non-vital molars with a high loss of residual tooth structure. LS material is more resistant compared to PICN.

Glioblastomas (GBM) are the most common and aggressive tumors of the central nervous system. Rapid tumor growth and diffuse infiltration into healthy brain tissue, along with high intratumoral heterogeneity, challenge therapeutic efficacy and prognosis. A better understanding of spatiotemporal tumor heterogeneity at the histological, cellular, molecular, and dynamic levels would accelerate the development of novel treatments for this devastating brain cancer. Histologically, GBM is characterized by nuclear atypia, cellular pleomorphism, necrosis, microvascular proliferation, and pseudopalisades. At the cellular level, the glioma microenvironment comprises a heterogeneous landscape of cell populations, including tumor cells, non-transformed/reactive glial and neural cells, immune cells, mesenchymal cells, and stem cells, which support tumor growth and invasion through complex network crosstalk. Genomic and transcriptomic analyses of gliomas have revealed significant inter and intratumoral heterogeneity and insights into their molecular pathogenesis. Moreover, recent evidence suggests that diverse dynamics of collective motion patterns exist in glioma tumors, which correlate with histological features. We hypothesize that glioma heterogeneity is not stochastic, but rather arises from organized and dynamic attributes, which favor glioma malignancy and influences treatment regimens. This review highlights the importance of an integrative approach of glioma histopathological features, single-cell and spatially resolved transcriptomic and cellular dynamics to understand tumor heterogeneity and maximize therapeutic effects.

Introdução: A doença mão-pé-boca (DMPB) é uma infeção aguda autolimitada, altamente contagiosa, de etiologia vírica, que ocorre sobretudo em crianças. O quadro clínico típico caracteriza-se pelo aparecimento de um enantema oral doloroso, seguido de lesões cutâneas nas palmas das mãos e plantas dos pés, de morfologia, tamanho e cor variáveis.O seu diagnóstico é sobretudo clínico, o tratamento sintomático e o prognóstico é, na maioria dos casos, favorável. O objetivo deste artigo é relatar um caso de DMPB num indivíduo adulto, alertando para a possibilidade deste diagnóstico nesta faixa etária. Descrição do caso: Apresenta-se o caso de um homem de 35 anos, com antecedentes de obesidade, rinite alérgica e história de varicela na infância, que recorreu à sua médica de família por pápulas pruriginosas nas palmas das mãos bilateralmente, associadas a odinofagia ligeira. Referia também ter estado em casa a cuidar do filho de 15 meses, com diagnóstico de DMPB, há cerca de sete dias. Assumiu-se o diagnóstico clínico de DMPB e foi tratado de forma sintomática. Dois dias depois regressou por extensão do exantema às plantas dos pés e à região perioral, tendo sido mantidos os cuidados. Na reavaliação, uma semana depois, apresentava descamação da pele das palmas das mãos e plantas dos pés e onicomadese das unhas das mãos e dos pés, sem surgimento de novas lesões. Considerou-se o quadro clínico em resolução e foram explicadas medidas de suporte e prevenção de contágio e recorrência. Comentário: A DMPB ocorre de forma esporádica em adultos. Nesta faixa etária, a doença acomete mais frequentemente indivíduos do sexo masculino e a atopia é considerada um fator de risco.O curso da doença é maioritariamente autolimitado, com resolução em sete a dez dias, sendo suficiente o tratamento de suporte.Apesar de raras, em determinadas populações as complicações associadas à DMPB podem condicionar risco de vida, o que juntamente com a sua elevada contagiosidade implica uma atitude clínica atenta e um diagnóstico precoce para prevenção da sua disseminação. Assim, perante um doente adulto que apresente início abrupto de exantema maculopapular das palmas das mãos e plantas dos pés, o diagnóstico de DPMB deve ser considerado.

High grade gliomas are malignant brain tumors that arise in the central nervous system, in patients of all ages. Currently, the standard of care, entailing surgery and chemo radiation, exhibits a survival rate of 14-17 months. Thus, there is an urgent need to develop new therapeutic strategies for these malignant brain tumors. Currently, immunotherapies represent an appealing approach to treat malignant gliomas, as the pre-clinical data has been encouraging. However, the translation of the discoveries from the bench to the bedside has not been as successful as with other types of cancer, and no long-lasting clinical benefits have been observed for glioma patients treated with immune-mediated therapies so far. This review aims to discuss our current knowledge about gliomas, their molecular particularities and the impact on the tumor immune microenvironment. Also, we discuss several murine models used to study these therapies pre-clinically and how the model selection can impact the outcomes of the approaches to be tested. Finally, we present different immunotherapy strategies being employed in clinical trials for glioma and the newest developments intended to harness the immune system against these incurable brain tumors.

Microorganisms living on marine macroalgal surfaces require enzyme repertoires to metabolize macroalgal-synthesized compounds. These enzymes are biological catalysts which have specific functional properties for biotechnological applications. Here, we raise awareness on the set of enzyme categories produced by the Bacillus altidudinis strain 19_A, isolated from the marine macroalga Ulva lactuca, as revealed by the analysis of its complete genome sequence. The genome of B. altitudinis strain 19_A is ∼3.7 Mb long, has a G + C content of 41.2 %, and contains a total of 3,967 protein-coding genes. Our predictive analysis revealed that these genes encode proteases, lipases, esterases, and enzymes involved in the synthesis, degradation, and modification of carbohydrates. This enzyme repertoire may have promising biotechnological and industrial applications.

BackgroundB-cell lymphomas are a diverse group of hematological neoplasms with differential etiology and clinical trajectories. Increased insights in the etiology and the discovery of prediagnostic markers have the potential to improve the clinical course of these neoplasms.MethodsWe investigated in a prospective study global gene expression in peripheral blood mononuclear cells of 263 incident B-cell lymphoma cases, diagnosed between 1 and 17 years after blood sample collection, and 439 controls, nested within two European cohorts.ResultsOur analyses identified only transcriptomic markers for specific lymphoma subtypes; few markers of multiple myeloma (N = 3), and 745 differentially expressed genes in relation to future risk of chronic lymphocytic leukemia (CLL). The strongest of these associations were consistently found in both cohorts and were related to (B-) cell signaling networks and immune system regulation pathways. CLL markers exhibited very high predictive abilities of disease onset even in cases diagnosed more than 10 years after blood collection.ConclusionsThis is the first investigation on blood cell global gene expression and future risk of B-cell lymphomas. We mainly identified genes in relation to future risk of CLL that are involved in biological pathways, which appear to be mechanistically involved in CLL pathogenesis. Many but not all of the top hits we identified have been reported previously in studies based on tumor tissues, therefore suggesting that a mixture of preclinical and early disease markers can be detected several years before CLL clinical diagnosis.

OBJECTIVES: The aim of this study was to estimate the attributable proportion (AP) of mesothelioma resulting from living in or close to major Italian industrially contaminated areas. METHODS: For populations living close to 39 sites of "national priority for remediation", incident mesothelioma cases were extracted from the Italian National Mesothelioma Registry (ReNaM) in the period 2000‒2011. Each site was classified in one of seven asbestos risk groups (RG) on the basis of the type of industrial plants. RG were ranked by the a priori evidence on asbestos risk. The AP for each RG was calculated as the meta-analytic estimate of AP of sites of the same group by gender and age class (0–64, 65–74, ≥75 years). The sex ratio (men/women) was computed for each RG. RESULTS: Among men, the AP by age class had the same gradient in each RG, with the highest values in the age class 0–64 years and the lowest in the ≥75 class; in the age class 0–64 years, the AP was positive in each RG, >90% in the presence of asbestos cement factories and harbors with shipyards. Among women, the overall AP decreased by RG, with negative values in the last two ranked RG; the AP by age class was variable without a definite gradient. The sex ratio was close to one only in the RG "only asbestos-cement factories"; the highest value (9.6) was observed in the age class 0–64 years in the RG "harbors with shipyard". CONCLUSIONS: The integration of a geographic- and case-based approach provides valuable insights into occupational and environmental determinants of mesothelioma risk in industrially contaminated sites.

Objective: To evaluate the clinical and surgical outcomes of the total hysterectomy cases performed with the laparoendoscopic single site surgery. Study Design: A total of 24 women who underwent total hysterectomy by the laparoendoscopic single site technique due to benign gynecological disorders were retrospectively evaluated. The duration of the operation, estimated blood loss, weight of the uterus, intra- and postoperative complications, pre- and postoperative day 1 hemoglobin and hematocrit levels, postoperative 6- and 24-hour visual analogue scale scores, duration of hospital stay, and postoperative complications were evaluated. Results: The mean total operation time was 112.1±24 minutes. The average time between the umbilical incision and starting the hysterectomy was 10±2.1 minutes. Estimated blood loss was 50±25 ml. The average duration of the hospital stay was 1.5±0.4 days. The mean uterus weight was 135 g. The mean difference between the pre- and postoperative hemoglobin values was 1.1 g/dl. The mean visual analogue scale scores were 4.1 (0-7) and 1.9 (0-4) in 6- and 24-hour postoperative periods. None of the women had an intraoperative complication. One patient (4.2%) had a port site hernia 6 months after the operation. Conclusion: The total hysterectomy with laparoendoscopic single site technique is a reasonable method in selected patients with similar safety and feasibility, especially for women who prefer a single incision in umbilicus. The patient should be informed before the operation about potential complications such as a port-site hernia.

This paper uses a theoretical perspective based on the ideas of Foucault, critical criminology, and rural criminology, to examine how social relations influenced tax evasion mechanisms in agriculture in the province of Córdoba, Argentina. The paper’s main contribution is to show how tax evasion mechanisms are deeply rooted in social relationships developed in the grain market. Through the analysis of thirty interviews, official statistics of tax evasion convictions, and administrative resolutions issued by the national tax agency, I argue that severe formal controls were unsuccessful in eradicating tax evasion because normative changes could not abruptly annul the social relations that made tax evasion in agriculture possible. On the contrary, tax evasion persisted, although some evasion mechanisms were left aside and new ones were created. Thus, it is necessary to stress the importance of a paper that studies economic crimes in geographic areas outside the global north, such as rural Argentina.

The present study aimed to evaluate the wear rate of polymer-infiltrated network composites and ceramics against enamel in a bruxism-simulated scenario. Ninety-six (n = 96) molars were divided into six groups (n = 16) according to their occlusal material: group 1—a polymer-infiltrated network ceramic (PINC); group 2—a second polymer-infiltrated network ceramic (PINC2); group 3—nanohybrid resin-based composite (CO); group 4—cubic zirconia (ZR); group 5—lithium disilicate (LS); and group 6—sound enamel (EN). A laser scanner was used to digitalize all of the occlusal surfaces before and after a fatigue test, which was conducted with a chewing simulator set at 80 N and semicircular movement in order to simulate bruxist movement and loads. Statistical analysis of volume loss was performed with a one-way ANOVA and post hoc Bonferroni test. ZR had significantly inferior wear to PINC (p ≤ 0.01) and CO (p = 0.04). LS wore the antagonist enamel significantly more than PINC, CO, PINC2 and EN (p ≤ 0.01). On the other hand, ZR wore the antagonist enamel significantly more than CO (p ≤ 0.01) and PINC2 (p = 0.05). In conclusion, PINCs better preserved antagonist enamel at the expense of a higher wear of their own. LS causes significantly higher enamel wear compared with PINCs. ZR caused significantly higher enamel wear compared with CO and PINC2, but it was wear-resistant.

INTRODUCCIÓN: Históricamente, el diagnóstico de una fractura medial de cadera requiere de una radiografía anteroposterior (AP) y de perfil (P). Nos propusimos analizar la importancia de la radiografía de perfil en la evaluación y planificación del tratamiento de las fracturas mediales de cadera, utilizando la clasificación de Garden. MATERIALES Y MÉTODOS: Se prepararon diapositivas con radiografías AP y de P de 100 pacientes con fracturas mediales de cadera admitidos en nuestra central de emergencias. Tres cirujanos de cadera evaluaron de forma independiente las incidencias AP únicamente y luego las vistas AP y P, utilizando la clasificación de Garden. RESULTADOS: Se utilizó el método de Kruskal Wallis para comparar los rangos en la clasificación de Garden después de ver la proyección de P y no se encontraron diferencias estadísticamente significativas (Kruskal Wallis 0, p=1). El acuerdo ponderado entre AP y el AP combinado con el P del Garden promedio fue de 81 % (p < 0.001). Se analizó el porcentaje de pacientes recategorizados entre fracturas no desplazadas y desplazadas, tras observar el perfil: 5% (n=5, IC 95% 1-11%) . Para comparar el Garden AP con el Garden P, se utilizó el método kappa ponderado cuadrático. CONCLUSIONES: Existe una alta concordancia en la clasificación de Garden al comparar las observaciones de las radiografías AP, con las observaciones AP y P juntas. Cinco pacientes hubiesen recibido un tratamiento quirúrgico diferente dependiendo del especialista que interpretaba las radiografías. Esto permite destacar la importancia de solicitar la incidencia de perfil de rutina en pacientes con sospecha de fractura medial de cadera. palabras clave: cadera; fracturas de cadera; prótesis de cadera; lesiones de la cadera; radiografía

Chimeric antigen receptor T-cell (CAR-T) therapy is a novel treatment for various types of hematologic malignancy. We presented a case of refractory diffuse large B cell lymphoma patient who developed acute invasive fungal rhinosinusitis (AIFR) from Fusarium species after CAR-T therapy. Our photos illustrated the classic clinical, endoscopic, and histopathologic findings of AIFR.

Modeling cancer cells is essential to better understand the dynamic nature of brain tumors and glioma cells, including their invasion of normal brain. Our goal is to study how the morphology of the glioma cell influences the formation of patterns of collective behavior such as flocks (cells moving in the same direction) or streams (cells moving in opposite direction) referred to as oncostream. We have observed experimentally that the presence of oncostreams correlates with tumor progression. We propose an original agent-based model that considers each cell as an ellipsoid. We show that stretching cells from round to ellipsoid increases stream formation. A systematic numerical investigation of the model was implemented in [Formula: see text]. We deduce a phase diagram identifying key regimes for the dynamics (e.g. formation of flocks, streams, scattering). Moreover, we study the effect of cellular density and show that, in contrast to classical models of flocking, increasing cellular density reduces the formation of flocks. We observe similar patterns in [Formula: see text] with the noticeable difference that stream formation is more ubiquitous compared to flock formation.

Epithelioid angiomyolipomas (EAMLs) are mesenchymal tumors that are part of the family of the perivascular epithelioid cell neoplasms (PEComas). These tumors portray a potential aggressive behavior with metastatic lesions found in around 30% of reported cases. EAMLs might present sporadically or in association with the tuberous sclerosis complex (TSC). They typically involve the kidneys, liver, and lungs. It is extremely rare for these tumors to arise from other organs. The present report describes an unusual case of an adult patient with a history of TSC who developed EAML of the adrenal gland. Moreover, he presented with metastatic disease to the liver, a feature rarely described. The diagnosis of EAMLs can be challenging as they are hard to distinguish from other adrenal or renal tumors without a thorough histopathologic and immunohistochemical evaluation. Due to the potential aggressive behavior of these malignancies, timely diagnosis is extremely important and has significant therapeutic and prognostic implications.

Macroalgae provide important habitats for microorganisms, with surfaces that are rich in nutrients and a microbial niche for isolation of different bacterial groups. In this study, we evaluated the production of enzymes (amylases, lipases, cellulases and agarases) and siderophores by strains isolated from the macroalga Ulva lactuca growing in the Santa Marta region of the Colombian Caribbean Sea. We taxonomically identified a subset of the bacteria and tested 207 bacterial isolates. Of these, 25 (12%) and 121 (58%) produced agarases and siderophores, respectively. Out of the isolated bacteria with amylolytic (97), cellulolytic (118) and lipolytic (26) activity, 31 (32%), 78 (66%) and 4 (15%) strains, respectively, produced a zone of clearance >1.5 cm, indicating substantial activity. Enzymatic activities and siderophore production were statistically different between years of sampling, and principal component analysis showed grouping for samples from the same year. These activities and production were recorded in bacterial strains belonging to the genera Vibrio, Pseudomonas and Bacillus. The results show that marine bacterial cultures isolated from the macroalga U. lactuca are a source of enzymes and siderophores that may have potential for biotechnological and industrial processes.

The purpose of this in vitro study was to evaluate the external marginal gap variation with a 3D quantitative method and the residual fracture resistance after cyclic fatigue in endodontically treated molars restored with overlays of different materials, with and without fiber posts-supported buildups. Forty-eight human maxillary molars were selected, endodontically treated, prepared with standardized MOD cavities and randomly allocated into 6 study groups considering the “core strategy” (build-up with composite resin; build-up with composite resin supported by a fiber post); and the “restorative material” of the indirect adhesive overlay (GrandioBlocks, Voco; Cerasmart, GC; CeltraDuo, Dentsply). All procedures were executed according with manufacturers guidelines. Micro-CT analysis prior and after cyclic fatigue were executed, followed by scanning electron microscope analysis and fracture resistance test. The Two-Way ANOVA analysis showed that interfacial gap progression was significantly influenced by the “core strategy” (p < 0.01) but not of “restorative material” (p = 0.59). Concerning fracture resistance, “restorative material” was statistically significant (p < 0.01), while “core strategy” (p = 0.63) and the interaction (p = 0.84) were not. In conclusion, the fiber post presence within the build-up promoted a lower interfacial gap opening after fatigue, evaluated through micro-CT scans. In terms of fracture resistance, teeth restored with Cerasmart and Celtra Duo were statistically similar, but superior to GrandioBlocks.