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The photoisomerization reaction of a fluorescent protein chromophore occurs on the ultrafast timescale. The structural dynamics that result from femtosecond optical excitation have contributions from vibrational and electronic processes and from reaction dynamics that involve the crossing through a conical intersection. The creation and progression of the ultrafast structural dynamics strongly depends on optical and molecular parameters. When using X-ray crystallography as a probe of ultrafast dynamics, the origin of the observed nuclear motions is not known. Now, high-resolution pump-probe X-ray crystallography reveals complex sub-ångström, ultrafast motions and hydrogen-bonding rearrangements in the active site of a fluorescent protein. However, we demonstrate that the measured motions are not part of the photoisomerization reaction but instead arise from impulsively driven coherent vibrational processes in the electronic ground state. A coherent-control experiment using a two-colour and two-pulse optical excitation strongly amplifies the X-ray crystallographic difference density, while it fully depletes the photoisomerization process. A coherent control mechanism was tested and confirmed the wave packets assignment.

Abstract We report time resolved observations of the crystallization from liquid hydrogen, supercooled to temperatures below the melting point, using 11.2 keV X-ray diffraction from the Linac Coherent Light Source (LCLS). Changes to the metastable solid and liquid structure factors have been dynamically measured. This allows for a direct determination of the lowest energy crystal polymorphs, the stacking probabilities, as well as the liquid and solid densities and temperatures. Such measurements provide experimental evidence of an Arrhenius-like growth kinetics along the stacking direction during supercooling.

Background: Serous endometrial carcinoma (SEC) is a high-risk subtype of endometrial cancer. The effectiveness of multiple adjuvant therapies, namely chemotherapy (CT), radiotherapy (RT), and sequential/concurrent chemotherapy with radiotherapy (CRT), have previously been investigated. However, optimal management of early-stage SEC remains unclarified. Methods: All cases of early-stage SEC (FIGO 2009 stages I–II) treated in our institution from 2002 to 2019 were identified. Patient data were documented until September 2023. Overall survival (OS) and disease-free survival (DFS) were computed using Kaplan–Meier estimates and Cox’s proportional hazard model; descriptive statistical analysis was performed. Results: A total of 50 patients underwent total hysterectomy-bilateral salpingo-oophorectomy and omentectomy, displaying stage IA (60%), IB (24%), and II (16%) disease. The median follow-up was 90.9 months. Patients underwent adjuvant CRT (n = 36, 72%), CT (n = 6, 12%), or RT (n = 6, 12%). Two patients were observed and excluded from analyses. The 42 patients who received radiotherapy had pelvic external beam radiotherapy (n = 10), vaginal brachytherapy (n = 21), or both (n = 11). CRT had better OS (HR 0.14, 95%CI 0.04–0.52, p < 0.005) and DFS (HR 0.25, 95%CI 0.07–0.97, p = 0.05) than CT alone. RT displayed no OS or DFS benefits compared to CT/CRT. Recurrences were mostly distant. Acute and late G3-4 toxicities were primarily hematologic. Conclusions: Our data underline the challenge of treating SEC. CRT appears to be superior to CT alone but not to RT. Most recurrences were distant, highlighting the need for optimized systemic treatment options.

A growing number of general circulation models are adapting interactive sulfur and aerosol schemes to improve the representation of relevant physical and chemical processes and associated feedbacks. They are motivated by investigations of climate response to major volcanic eruptions and potential solar geoengineering scenarios. However, uncertainties in these schemes are not well constrained. Stratospheric sulfate is modulated by emissions of sulfur-containing species of anthropogenic and natural origin, including volcanic activity. While the effects of volcanic eruptions have been studied in the framework of global model intercomparisons, the background conditions of the sulfur cycle have not been addressed in such a way. Here, we fill this gap by analyzing the distribution of the main sulfur species in nine global atmospheric aerosol models for a volcanically quiescent period. We use observational data to evaluate model results. Overall, models agree that the three dominant sulfur species in terms of burdens (sulfate aerosol, OCS, and SO2) make up about 98 % stratospheric sulfur and 95 % tropospheric sulfur. However, models vary considerably in the partitioning between these species. Models agree that anthropogenic emission of SO2 strongly affects the sulfate aerosol burden in the northern hemispheric troposphere, while its importance is very uncertain in other regions, where emissions are much lower. Sulfate aerosol is the main deposited species in all models, but the values deviate by a factor of 2. Additionally, the partitioning between wet and dry deposition fluxes is highly model dependent. Inter-model variability in the sulfur species is low in the tropics and increases towards the poles. Differences are largest in the dynamically active northern hemispheric extratropical region and could be attributed to the representation of the stratospheric circulation. The differences in the atmospheric sulfur budget among the models arise from the representation of both chemical and dynamical processes, whose interplay complicates the bias attribution. Several problematic points identified for individual models are related to the specifics of the chemistry schemes, model resolution, and representation of cross-tropopause transport in the extratropics. Further model intercomparison research is needed with a focus on the clarification of the reasons for biases, given the importance of this topic for the stratospheric aerosol injection studies.

Este relato de experiência apresenta uma ação extensionista desenvolvida, em 2019, entre a Universidade Federal de Ouro Preto (UFOP) e a Secretaria de Desenvolvimento Social e Cidadania (SEDESC) de Mariana (MG), junto ao Programa/Serviço Jovem Aprendiz. Nosso objetivo foi mediar reflexões sobre o (re)conhecimento das identidades juvenis marianenses, numa perspectiva interseccional, buscando contribuir para uma formação cidadã crítica da realidade social, a partir das narrativas de autoras/es negras/os. Utilizamos o método de Oficinas em Dinâmicas de Grupo. Como resultados, identificamos uma ausência de escritoras/es negras/os em espaços institucionais, situação suprida por manifestações artísticas literárias, repletas de críticas sociais, que possibilitaram a reflexão sobre os processos de desigualdade social, bem como caminhos para o seu enfrentamento. Concluímos que estas manifestações foram fundamentais para a (re)construção das narrativas a partir das vozes e trajetórias das/dos jovens.

Abstract The aim of this study is to determine if extended‐release, bioabsorbable, subcutaneous naltrexone (NTX) implants can mitigate respiratory depression after an intravenous injection (IV) of fentanyl. Six different BIOabsorbable Polymeric Implant Naltrexone (BIOPIN) formulations, comprising combinations of Poly‐d,l‐Lactic Acid (PDLLA) and/or Polycaprolactone (PCL‐1 or PCL‐2), were used to create subcutaneous implants. Both placebo and naltrexone implants were implanted subcutaneously in male dogs. The active naltrexone implants consisted of two doses, 644 mg and 1288 mg. A challenge with IV fentanyl was performed in 33 male dogs at 97–100 days after implantation. Following the administration of a 30 μg/kg intravenous fentanyl dose, the placebo cohort manifested a swift and profound respiratory depression with a ~50% reduction in their pre‐dose respiratory rate (RR). The BIOPIN NTX‐implanted dogs were exposed to escalating doses of intravenous fentanyl (30 μg/kg, 60 μg/kg, 90 μg/kg, and 120 μg/kg). In contrast, the dogs implanted with the BIOPIN naltrexone implants tolerated doses up to 60 μg/kg without significant respiratory depression (

Abstract Introduction The rapid development of artificial intelligence (AI) in healthcare has exposed the unmet need for growing a multidisciplinary workforce that can collaborate effectively in the learning health systems. Maximizing the synergy among multiple teams is critical for Collaborative AI in Healthcare. Methods We have developed a series of data, tools, and educational resources for cultivating the next generation of multidisciplinary workforce for Collaborative AI in Healthcare. We built bulk‐natural language processing pipelines to extract structured information from clinical notes and stored them in common data models. We developed multimodal AI/machine learning (ML) tools and tutorials to enrich the toolbox of the multidisciplinary workforce to analyze multimodal healthcare data. We have created a fertile ground to cross‐pollinate clinicians and AI scientists and train the next generation of AI health workforce to collaborate effectively. Results Our work has democratized access to unstructured health information, AI/ML tools and resources for healthcare, and collaborative education resources. From 2017 to 2022, this has enabled studies in multiple clinical specialties resulting in 68 peer‐reviewed publications. In 2022, our cross‐discipline efforts converged and institutionalized into the Center for Collaborative AI in Healthcare. Conclusions Our Collaborative AI in Healthcare initiatives has created valuable educational and practical resources. They have enabled more clinicians, scientists, and hospital administrators to successfully apply AI methods in their daily research and practice, develop closer collaborations, and advanced the institution‐level learning health system.

La gestión del conocimiento se ha convertido en un concepto central en la estrategia empresarial y en la búsqueda de ventajas competitivas en la economía actual. En la actualidad, el valor de una empresa no se basa únicamente en sus activos físicos, como las fábricas o el equipo, sino en su capacidad para generar, adquirir y aplicar el conocimiento de manera efectiva. La capacidad de una empresa para introducir nuevos productos, servicios, procesos o modelos de negocio es esencial para mantenerse relevante y competitiva. Por ello, el objetivo del presente trabajo es analizar el diseño de estrategias efectivas de gestión del conocimiento para fomentar la innovación. Se optó por emplear la metodología de investigación documental bibliográfica. Para el diseño de estrategias efectivas, es esencial comprender las necesidades y la cultura específica de la organización, además, fomentar una cultura de innovación, la elección de tecnologías adecuadas y un liderazgo comprometido, son factores críticos del éxito. La gestión del conocimiento no solo mejora la toma de decisiones y la eficiencia operativa, sino que también desencadena la creatividad y la generación de ideas innovadoras.

The Goddard Chemistry Aerosol Radiation and Transport (GOCART) model, which controls the sources, sinks, and chemistry of aerosols within the Goddard Earth Observing System (GEOS), recently underwent a major refactoring and update, including a revision of the emissions datasets and the addition of brown carbon. A 4-year benchmark simulation utilizing the new version of the model code, termed GOCART Second Generation (GOCART-2G) and coupled to the Goddard Earth Observing System (GEOS) model, was evaluated using in situ and spaceborne measurements to develop a baseline and prioritize future development. A comparison of simulated aerosol optical depth between GOCART-2G and MODIS retrievals indicates the model captures the overall spatial pattern and seasonal cycle of aerosol optical depth but overestimates aerosol extinction over dusty regions and underestimates aerosol extinction over Northern Hemisphere boreal forests, requiring further investigation and tuning of emissions. This MODIS-based analysis is corroborated by comparisons to MISR and selected AERONET stations; however, discrepancies between the Aqua and Terra satellites indicate there is a diurnal component to biases in aerosol optical depth over southern Asia and northern Africa. Despite the underestimate of aerosol optical depth in biomass burning regions in GEOS, there is an overestimate in the surface mass of organic carbon in the United States, especially during the summer months. Over Europe, GOCART-2G is unable to match the summertime peak in aerosol optical depth, opposing the observed late fall and early spring peaks in surface mass concentration. A comparison of the vertical profile of attenuated backscatter to observations from CALIPSO indicates the GEOS model is capable of capturing the vertical profile of aerosol; however, the mid-troposphere plumes of dust in the North Atlantic and smoke in the southeastern Atlantic are perhaps too low in altitude. The results presented highlight priorities for future development with GOCART-2G, including improvements for dust, biomass burning aerosols, and anthropogenic aerosols.

Reversibly photoswitchable fluorescent proteins are essential markers for advanced biological imaging, and optimization of their photophysical properties underlies improved performance and novel applications. Here we establish a link between photoswitching contrast, one of the key parameters that dictate the achievable resolution in nanoscopy applications, and chromophore conformation in the non-fluorescent state of rsEGFP2, a widely employed label in REversible Saturable OpticaL Fluorescence Transitions (RESOLFT) microscopy. Upon illumination, the cis chromophore of rsEGFP2 isomerizes to two distinct off-state conformations, trans1 and trans2, located on either side of the V151 side chain. Reducing or enlarging the side chain at this position (V151A and V151L variants) leads to single off-state conformations that exhibit higher and lower switching contrast, respectively, compared to the rsEGFP2 parent. The combination of structural information obtained by serial femtosecond crystallography with high-level quantum chemical calculations and with spectroscopic and photophysical data determined in vitro suggests that the changes in switching contrast arise from blue- and red-shifts of the absorption bands associated to trans1 and trans2, respectively. Thus, due to elimination of trans2, the V151A variants of rsEGFP2 and its superfolding variant rsFolder2 display a more than two-fold higher switching contrast than their respective parent proteins, both in vitro and in E. coli cells. The application of the rsFolder2-V151A variant is demonstrated in RESOLFT nanoscopy. Our study rationalizes the connection between structural and photophysical chromophore properties and suggests a means to rationally improve fluorescent proteins for nanoscopy applications.

BackgroundAlterations in the gut microbiome have been associated with HIV infection, but the relative impact of HIV versus other factors on the gut microbiome has been difficult to determine in cross-sectional studies.MethodsTo address this, we examined the gut microbiome, serum metabolome, and cytokines longitudinally within 27 individuals before and during acute HIV using samples collected from several ongoing cohort studies. Matched control participants (n=28) from the same cohort studies without HIV but at similar behavioral risk were used for comparison.FindingsWe identified few changes in the microbiome during acute HIV infection, but did find alterations in serum metabolites involving secondary bile acid (lithocholate sulfate, glycocholenate sulfate) and amino acid metabolism (3-methyl-2-oxovalerate, serine, cysteine, N-acetylputrescine). Greater microbiome differences, including decreased Bacteroides spp and increased Megasphaera elsdenii, were seen when comparing pre-HIV infection visits to matched at-risk controls. Those who acquired HIV also had elevated inflammatory cytokines (TNF-α, B cell activating factor, IL-8) and bioactive lipids (palmitoyl-sphingosine-phosphoethanolamide and glycerophosphoinositol) prior to HIV acquisition compared to matched controls.InterpretationLongitudinal sampling identified pre-existing microbiome differences in participants with acute HIV compared to matched control participants observed over the same period. These data highlight the importance of increasing understanding of the role of the microbiome in HIV susceptibility.FundingThis work was supported by NIH/NIAID (K08AI124979; P30AI117943), NIH/NIDA (U01DA036267; U01DA036939; U01DA036926; U24DA044554), and NIH/NIMH (P30MH058107; R34MH105272).

This article is an update to a previous article on the online embedded librarian program at Athens State University. It examines the nature of embedded librarianship at Athens State University and how it has grown and evolved over the past fifteen years. The authors review the literature and provide definitions and best practices associated with embedded librarianship as well as various levels of embedded librarian involvement. They also provide suggestions for those involved in embedded librarianship.

Introduction: This study addresses the experience of incarcerated mothers of infants in Peru, focusing on their feelings of regret and their longing for family reunification. Objective: To explore the experiences of regret and hope for family reunion among incarcerated mothers of infants, to better understand the emotional and social impact of imprisonment and to highlight the importance of family support in the social reintegration process. Methods: The study adheres to a naturalistic paradigm, employing a qualitative approach with a hermeneutic phenomenological design. Data collection was conducted through workshops and semi-structured interviews with 29 incarcerated women, focusing on the mother-child relationship, adversity and communication for personal growth. The workshops facilitated reflection and authentic expression on themes of relational bonding, destiny in the face of adversity and communication for personal development. Throughout the process, informed consent, confidentiality, and participant privacy were prioritized. Results: Participants expressed profound regret, highlighting sadness, pain, and the desire not to reoffend. The hope for family reunification emerged as a strong motivator for their rehabilitation. Semantic networks revealed the importance of family reconnection, love, and personal overcoming in their future aspirations. Conclusions: The study showed how regret and hope for family reunion are crucial for their emotional well-being and reintegration process. It also highlighted the need for policies and support programs that specifically address the needs of incarcerated mothers and their families to facilitate rehabilitation and the reconstruction of family life after incarceration.

Abstract Background Coronavirus disease COVID-19 is a heterogeneous condition caused by SARS-CoV-2 infection. Generally, it is characterized by interstitial pneumonia that can lead to impaired gas-exchange, acute respiratory failure, and death, although a complex disorder of multi-organ dysfunction has also been described. The pathogenesis is complex, and a variable combination of factors has been described in critically ill patients. COVID-19 is a particular risk for older persons, particularly those with frailty and comorbidities. Blood bacterial DNA has been reported in both physiological and pathological conditions and has been associated with some haematological and laboratory parameters but, to date, no study has characterized it in hospitalized old COVID-19 patients The present study aimed to establish an association between blood bacterial DNA (BB-DNA) and clinical severity in old COVID-19 patients. Results BB-DNA levels were determined, by quantitative real-time PCRs targeting the 16S rRNA gene, in 149 hospitalized older patients (age range 65–99 years) with COVID-19. Clinical data, including symptoms and signs of infection, frailty status, and comorbidities, were assessed. BB-DNA was increased in deceased patients compared to discharged ones, and Cox regression analysis confirmed an association between BB-DNA and in-hospital mortality. Furthermore, BB-DNA was positively associated with the neutrophil count and negatively associated with plasma IFN-alpha. Additionally, BB-DNA was associated with diabetes. Conclusions The association of BB-DNA with mortality, immune-inflammatory parameters and diabetes in hospitalized COVID-19 patients suggests its potential role as a biomarker of unfavourable outcomes of the disease, thus it could be proposed as a novel prognostic marker in the assessment of acute COVID-19 disease.

Marfan Syndrome (MFS) is an autosomal dominant disease caused in most cases by mutations in the FNB1 gene, which encodes for fibrillin 1. MFS does not alway shows typical phenotypic signs. Indeed, the occurrence of sudden death of unknown cause is increasingly seen in young adults without ante mortem preexisting pathology to explain the event. In many cases the diagnosis of Marfan Syndrome (MFS) is carried out post mortem, especially in cases where the disease’s external phenotype is absent. Here is reported a case of a young woman who died during a twin pregnancy investigated with medico-legal and forensic anthropological procedures. The autopsy showed the absence of a typical marfanoid habitus and the presence of a dissecting aneurysm of the aorta with histopathological degeneration of the aortic elastic fibers. The genetic investigation revealed two previously undetected de novo mutations of the FBN1 gene: c.T6181C: p.C2061R and c.G1415A: p.C472Y. This new mutations, together with a comprehensive analysis, demonstrates the existence of a causal relationship between these mutations and the dissecting aneurysm of the aorta. This also stresses the importance of a combined multidisciplinary approach to this condition which includes morphological and genetic studies.

Adrenomedullin (ADM) is a vasodilatory peptide that plays a crucial role in maintaining cardiovascular health through its various biological functions. ADM was discovered in the acidic extract of human pheochromocytoma tissue and has been recognized for its significant effects on the vascular system. The main functions of ADM include vasodilation, controlling blood pressure and maintaining vascular integrity, although its role on cardiovascular health is broader. Research has shown that elevated levels of adrenomedullin have been observed in a large number of severe diseases, with high risk of death. In this work, we examined the role of ADM as a predictive molecule of the risk of mortality and adverse clinical outcome through a narrative review of the scientific literature. The results were divided based on the pathologies and anatomical districts examined. This review demonstrates how ADM shows, in many diseases and different systems, a close correlation with the risk of mortality. These results prove the value of ADM as a prognostic marker in various clinical contexts and diseases, with utility in the stratification of the risk of clinical worsening and/or death and in the evaluation of therapeutic efficacy. The results open new perspectives with respect to the concrete possibility that ADM enters clinical practice as an effective diagnostic and prognostic marker of death as well as a molecular target for therapies aimed at patient survival.

Fentanyl is an opioid with powerful analgesic effects and a high speed of action. Due to its pharmacological properties, this molecule has therapeutic application as an anesthetic in surgery or as palliative therapy for cancer patients. Unfortunately, in recent years, the easy availability of this substance, the low cost and the illegal online market have favored the large-scale diffusion of fentanyl. Fentanyl is available in different forms, including nasal spray, oral patches, soluble capsules, aerosol or the new version of fentanyl mixed with other drugs, making its use very widespread. Subjects of various ages are involved in fentanyl consumption, including minors that have not yet reached adolescence. In this work, we performed a literature review using the search engines PubMed NCBI and SCOPUS regarding episodes of acute fentanyl intoxication occurring in those of a pediatric age using the Mesh Terms “fentanyl” AND “overdose” AND “children”. The inclusion criteria were English papers published in the last 10 years regarding the cases of children under the age of 10. We evaluated the most frequent methods of intake and the circumstances of such episodes. In cases of death, we analyzed the autopsy, the toxicological findings and the investigations carried out. The review results show that in this age group (under < 10 y.o. s), it is possible to identify the risk factors for fentanyl intake, such as the presence of this molecule within the family unit due to drug addiction or medical therapy. The results also demonstrate a significant risk of underestimation of this phenomenon, since the molecule is often not investigated through adequate toxicological analysis. These results, therefore, suggest always carrying out toxicological investigations in the case of suspected fentanyl intoxication, both on patients or cadavers. The investigations must always include a urinary screening for opiates, and the request for a second level analysis with molecule dosage in cases of positivity or in cases of strong suspicion for assumption. In cases of intoxication in a family context of drug addiction, it is necessary to investigate the chronicity of the intake through hair analysis and evaluate the possible co-administration of other drugs. In conclusion, we suggest a protocol, applicable both on patients or cadavers, which can be useful for physicians and forensic pathologists in order to promptly identify these cases and allow for the reporting of them to the judicial authorities with the adoption of strict prevention and control measures.

With the widespread phenomenon of antibiotic resistance and the diffusion of multiple drug-resistant bacterial strains, enormous efforts are being conducted to identify suitable alternative agents against pathogenic microorganisms. Since an association between biofilm formation and antibiotic resistance phenotype has been observed, a promising strategy pursued in recent years focuses on controlling and preventing this formation by targeting and inhibiting the Quorum Sensing (QS) system, whose central role in biofilm has been extensively demonstrated. Therefore, the research and development of Quorum Quenching (QQ) compounds, which inhibit QS, has gradually attracted the attention of researchers and has become a new strategy for controlling harmful microorganisms. Among these, a number of both natural and synthetic compounds have been progressively identified as able to interrupt the intercellular communication within a microbial community and the adhesion to a surface, thus disintegrating mature/preformed biofilms. This review describes the role played by QS in the formation of bacterial biofilms and then focuses on the mechanisms of different natural and synthetic QS inhibitors (QSIs) exhibiting promising antibiofilm ability against Gram-positive and Gram-negative bacterial pathogens and on their applications as biocontrol strategies in various fields.

At many crime scenes, investigators are able to trace and find traces of blood. For many years, it was believed that such traces could only be subjected to genetic investigations, such as those aimed at comparing DNA profiling with a suspect to verify his identity, and that it was therefore not possible to backdate the traces. In recent years, various works have used experimental models to investigate the possibility of identifying markers and methodologies for estimating the time since deposition (TSD) of bloodstains. Despite the results, these methods are still not part of standard procedures, and there is no univocal analysis methodology. In this work we carried out a systematic literature review of all the papers published in the last ten years on this topic, comparing the experimental models created. This review demonstrates the potential that different molecular approaches, such as transcriptomics, metabolomics, proteomics, and spectrometry, can have in the analysis of TSD, with notable sensitivity and specificity. This paper also analyzes the intrinsic and extrinsic limits of these models and emphasizes the need to continue research work on this topic, considering the importance that this parameter can assume in forensic investigations against a suspect.

ObjectivesWe examined whether molecular cluster membership was associated with public health identification of HIV transmission potential among named partners in Chicago.DesignHistorical cohort study.MethodsWe matched and analyzed HIV surveillance and partner services data from HIV diagnoses (2012-2016) prior to implementation of cluster detection and response interventions. We constructed molecular clusters using HIV-TRACE at a pairwise genetic distance threshold of 0.5% and identified clusters exhibiting recent and rapid growth according to the Centers for Disease Control and Prevention definition (three new cases diagnosed in past year). Factors associated with identification of partners with HIV transmission potential were examined using multivariable Poisson regression.ResultsThere were 5208 newly diagnosed index clients over this time period. Average age of index clients in clusters was 28; 47% were Black, 29% Latinx/Hispanic, 6% female and 89% MSM. Of the 537 named partners, 191 (35.6%) were linked to index cases in a cluster and of those 16% were either new diagnoses or viremic. There was no statistically significant difference in the probability of identifying partners with HIV transmission potential among index clients in a rapidly growing cluster versus those not in a cluster [adjusted relative risk 1.82, (0.81-4.06)].ConclusionPartner services that were initiated from index clients in a molecular cluster yielded similar new HIV case finding or identification of those with viremia as did interviews with index clients not in clusters. It remains unclear whether these findings are due to temporal disconnects between diagnoses and cluster identification, unobserved cluster members, or challenges with partner services implementation.

The coexistence allows the adaptation of the aggressors and assaulted in school communities through artistic interaction techniques. Due to its transformational value, artivist education allows students to be involved in raising awareness of their environment as well as themselves. For this reason, the interest of the research was to determine the benefits of artivism in school coexistence. Three studies based on sustainability, school exchange and meaning analysis were carried out in 80 fifth and sixth grade primary students. Measurement scales and the log of experiences were used, from whose data it was obtained that there was greater sustainability of direct and democratic coexistence from the fourth month of experimentation with activities based on artivist education (Experiment 1), as well as effects on school exchange with greater emphasis on the democratic component (Experiment 2). The conclusions of the research invited to deduce that artivist education allowed coexistence to be made more sustainable through the strategies that subjects adopted from their peers, in turn, direct interaction allowed to propose a formative process of adaptation between assaulted and aggressors. As a contribution, the research highlights the adoption of new forms of student interaction with power groups to the extent of how and how they establish acceptability behaviors in the shared context.

Malaysia and ASEAN society are rich with a variety of traditional games and usually played during leisure time. 'Tossing the Stones' or Batu Seremban was chosen in this survey. Using a purposive sampling technique, respondents from Malaysia, Philippines, Indonesia and Thailand went through the game intervention and answered the questionnaires provided. The goal was to understand how they perceived wellness while playing this game, after identifying the frequency of Traditional Games engagement. Results showed that Batu Seremban gave high wellness scores such as; M=4.16, SD=0.722. The physical, intellectual, social and emotional elements identified in 'Tossing the Stones' showed that strong educational elements identified in the traditional leisure game can also be used to teach children and young adults through integration in the curriculum. Suggestions on how the game can be used in classrooms were made based on the findings.

Introduction: Postural instability (PI) is a common disabling symptom in Parkinson’s disease (PD) patients, but the brain alterations underlying this sign are not fully understood yet. This study aimed to investigate the association between PI and callosal damage in PD and progressive supranuclear palsy (PSP) patients, using multimodal MR imaging. Methods: One-hundred and two PD patients stratified according to the presence/absence of PI (PD-steady N=58; PD-unsteady N=44), 69 PSP patients, and 38 healthy controls (HC) underwent structural and diffusion 3T brain MRI. Thickness, fractional anisotropy (FA) and mean diffusivity (MD) were calculated over 50 equidistant points covering the whole midsagittal profile of the corpus callosum (CC) and compared among groups. Associations between imaging metrics and postural instability score were investigated using linear regression. Results: Both PSP and PD-unsteady patient groups showed CC involvement in comparison with HC, while no difference was found between PD-steady patients and controls. The CC damage was more severe and widespread in PSP than in PD patients. The CC genu was the regions most damaged in PD-unsteady patients compared with PD-steady patients, showing significant microstructural alterations of MD and FA metrics. Linear regression analysis pointed at the MD in the CC genu as the main contributor to PI among the considered MRI metrics. Conclusion: This study identified callosal microstructural alterations associated with PI in unsteady PD and PSP patients, which provide new insights on PI pathophysiology and might serve as imaging biomarkers for assessing postural instability progression and treatment response.

We established consensus on practice-based metrics that characterize quality of care for older primary care patients and can be examined using secondary health administrative data. We conducted a two-round RAND/UCLA Appropriateness Method (RAM) study and recruited 10 Canadian clinicians and researchers with expertise relevant to the primary care of elderly patients. Informed by a literature review, the first RAM round evaluated the appropriateness and importance of candidate quality measures in an online questionnaire. Technical definitions were developed for each endorsed indicator to specify how the indicator could be operationalized using health administrative data. In a virtual synchronous meeting, the expert panel offered feedback on the technical specifications for the endorsed indicators. Panelists then completed a second (final) questionnaire to rate each indicator and corresponding technical definition on the same criteria (appropriateness and importance). We used statistical integration to combine technical expert panelists' judgements and content analysis of open-ended survey responses. Our literature search and internal screening resulted in 61 practice-based quality indicators for rating. We developed technical definitions for indicators endorsed in the first questionnaire (n = 55). Following the virtual synchronous meeting and second questionnaire, we achieved consensus on 12 practice-based quality measures across four Priority Topics in Care of the Elderly. The endorsed indicators provide a framework to characterize practice- and population-level encounters of family physicians delivering care to older patients and will offer insights into the outcomes of their care provision. This study presented a case of soliciting expert feedback to develop measurable practice-based quality indicators that can be examined using administrative data to understand quality of care within population-based data holdings. Future work will refine and operationalize the technical definitions established through this process to examine primary care provision for older adults in a particular context (Ontario, Canada).

Inorganic-organic hybrid materials represent a large share of newly reported structures, owing to their simple synthetic routes and customizable properties1. This proliferation has led to a characterization bottleneck: many hybrid materials are obligate microcrystals with low symmetry and severe radiation sensitivity, interfering with the standard techniques of single-crystal X-ray diffraction2,3 and electron microdiffraction4-11. Here we demonstrate small-molecule serial femtosecond X-ray crystallography (smSFX) for the determination of material crystal structures from microcrystals. We subjected microcrystalline suspensions to X-ray free-electron laser radiation12,13 and obtained thousands of randomly oriented diffraction patterns. We determined unit cells by aggregating spot-finding results into high-resolution powder diffractograms. After indexing the sparse serial patterns by a graph theory approach14, the resulting datasets can be solved and refined using standard tools for single-crystal diffraction data15-17. We describe the ab initio structure solutions of mithrene (AgSePh)18-20, thiorene (AgSPh) and tethrene (AgTePh), of which the latter two were previously unknown structures. In thiorene, we identify a geometric change in the silver-silver bonding network that is linked to its divergent optoelectronic properties20. We demonstrate that smSFX can be applied as a general technique for structure determination of beam-sensitive microcrystalline materials at near-ambient temperature and pressure.

BackgroundHIV intervention activities directed toward both those most likely to transmit and their HIV-negative partners have the potential to substantially disrupt HIV transmission. Using HIV sequence data to construct molecular transmission clusters can reveal individuals whose viruses are connected. The utility of various cluster prioritization schemes measuring cluster growth have been demonstrated using surveillance data in New York City and across the United States, by the Centers for Disease Control and Prevention (CDC).MethodsWe examined clustering and cluster growth prioritization schemes using Illinois HIV sequence data that include cases from Chicago, a large urban center with high HIV prevalence, to compare their ability to predict future cluster growth.ResultsWe found that past cluster growth was a far better predictor of future cluster growth than cluster membership alone but found no substantive difference between the schemes used by CDC and the relative cluster growth scheme previously used in New York City (NYC). Focusing on individuals selected simultaneously by both the CDC and the NYC schemes did not provide additional improvements.ConclusionGrowth-based prioritization schemes can easily be automated in HIV surveillance tools and can be used by health departments to identify and respond to clusters where HIV transmission may be actively occurring.

Abstract Background Immediate initiation of antiretroviral treatment (iART) is a proven intervention that significantly decreases time to viral suppression and increases patient retention. iART involves starting medication as early as possible, often after a reactive rapid HIV test or re-engagement in care, although it does not have a universal definition. We aimed to understand iART from an implementation science perspective in a wide range of New York City (NYC) clinics providing HIV primary care, including staff knowledge, attitudes, and practices, as well as clinic barriers and facilitators to iART. Methods We used a mixed-methods, convergent study design, with a quantitative survey and in-depth interview (IDI), to understand individual-level knowledge, attitudes, and practices, as well as clinic-level barriers and facilitators to iART. We recruited at least one medical and non-medical staff member from a diverse purposive sample of 30 NYC clinics. In quantitative analyses, we used separate binomial logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (95% CI). In qualitative analyses, we used codebooks created by thematic analyses structured using a Framework Model to develop descriptive analytic memos. Results Recruited staff completed 46 surveys and 17 IDIs. We found high levels of awareness of the viral suppression and retention in care benefits of iART. Survey respondents more commonly reported medication starts within three to four days of a reactive rapid HIV test rather than same-day initiation. Among survey respondents, compared to medical staff, non-medical staff were more likely to agree that medication should only be initiated after receiving confirmatory HIV test results (OR: 0.2, 95% CI: 0.06–0.8). Additionally, survey respondents from clinics serving a majority people of color were less likely to report iART on the same day as a reactive rapid HIV test (OR: 0.2, 95% CI: 0.02–1.0, p-value

El recurso natural suelo en Cuba muestra un alto grado de deterioro. Las transformaciones en la agricultura cubana apuntan cada vez más a nuevos usufructuarios de la tierra. Dentro de ellos, el incremento de fincas familiares es creciente. Por lo que, resulta primordial la asesoría técnica a los emprendedores que asumen esta modalidad. El objetivo del presente trabajo fue realizar análisis físicos, químicos y biológicos al suelo en la Finca familiar Maripa. Se identificaron los campos (tratamientos) y se adecuaron a un diseño experimental en Bloques al azar con nueve tratamientos y cuatro réplicas. Los datos se procesaron estadísticamente, mediante un ANOVA de clasificación simple. Independientemente de las diferencias estadísticas que pudieran existir, los suelos en los sitios estudiados presentaron gran similitud. Las observaciones arrojaron un suelo no plástico, erosionado, con un predominio alto de arena, coeficiente de permeabilidad excelente, factor de estructura y estabilidad de los agregados malos y baja porosidad, con peso específico mayormente mediano y densidad aparente alta, que indica un predominio de compactación del suelo. El pH de ligero a medianamente ácido, contenido de materia orgánica y reserva de carbono en el suelo muy bajo, al igual que el fósforo asimilable. Se concluye que los suelos de la finca presentan un marcado deterioro de sus principales componentes físicos, químicos y biológicos que pueden afectar su fertilidad. Se recomienda aplicar un programa integral de mejoramiento del suelo a corto y mediano plazo para facilitar una recuperación paulatina de su productividad.

The spread of antibiotic-resistant pathogens has prompted the development of novel approaches to identify molecules that synergize with antibiotics to enhance their efficacy. This study aimed to investigate the effects of ten Essential Oils (EOs) on the activity of nine antibiotics in influencing growth and biofilm formation in Escherichia coli, Pseudomonas aeruginosa, and Enterococcus faecalis. The effects of the EOs alone and in combination with antibiotics on both bacterial growth and biofilm formation were analyzed by measuring the MIC values through the broth microdilution method and the crystal violet assay, respectively. All EOs inhibited the growth of E. coli (1.25 ≤ MIC ≤ 5 mg/mL) while the growth of P. aeruginosa and E. faecalis was only affected by EOs from Origanum vulgare, (MIC = 5 mg/mL) and O. vulgare (MIC = 1.25 mg/mL) and Salvia rosmarinus (MIC = 5 mg/mL), respectively. In E. coli, most EOs induced a four- to sixteen-fold reduction in the MIC values of ampicillin, ciprofloxacin, ceftriaxone, gentamicin, and streptomycin, while in E. faecalis such a reduction is observed in combinations of ciprofloxacin with C. nepeta, C. bergamia, C. limon, C. reticulata, and F. vulgare, of gentamicin with O. vulgare, and of tetracycline with C. limon and O. vulgare. A smaller effect was observed in P. aeruginosa, in which only C. bergamia reduced the concentration of tetracycline four-fold. EO-antibiotic combinations also inhibit the biofilm formation. More precisely, all EOs with ciprofloxacin in E. coli, tetracycline in P. aeruginosa, and gentamicin in E. faecalis showed the highest percentage of inhibition. Combinations induce up- and down-methylation of cytosines and adenines compared to EO or antibiotics alone. The study provides evidence about the role of EOs in enhancing the action of antibiotics by influencing key processes involved in resistance mechanisms such as biofilm formation and epigenetic changes. Synergistic interactions should be effectively considered in dealing with pathogenic microorganisms.

Abstract Femtosecond pump-probe spectroscopy using ultrafast optical and infrared pulses has become an essential tool to discover and understand complex electronic and structural dynamics in solvated molecular, biological, and material systems. Here we report the experimental realization of an ultrafast two-color X-ray pump X-ray probe transient absorption experiment performed in solution. A 10 fs X-ray pump pulse creates a localized excitation by removing a 1s electron from an Fe atom in solvated ferro- and ferricyanide complexes. Following the ensuing Auger–Meitner cascade, the second X-ray pulse probes the Fe 1s → 3p transitions in resultant novel core-excited electronic states. Careful comparison of the experimental spectra with theory, extracts +2 eV shifts in transition energies per valence hole, providing insight into correlated interactions of valence 3d with 3p and deeper-lying electrons. Such information is essential for accurate modeling and predictive synthesis of transition metal complexes relevant for applications ranging from catalysis to information storage technology. This study demonstrates the experimental realization of the scientific opportunities possible with the continued development of multicolor multi-pulse X-ray spectroscopy to study electronic correlations in complex condensed phase systems.

Introduction: In postmenopausal women, vitamin D deficiency has been associated with disability, low muscle mass and fractures. Irisin is an important myokine that may contribute to the maintenance of muscle and bone density. Vitamin D is associated with the growth and function of muscle tissue through interactions between the vitamin D receptor and PGC-1α and activation of p38/MAPK (mitogen-activated protein kinase) in muscle, a mechanism similar to irisin action. The aim of this pilot study was to evaluate the effects of cholecalciferol supplementation on serum irisin levels in sedentary postmenopausal women with hypovitaminosis D (25(OH)D

Natural α-glucosidase inhibitors from plant-based foods such as catechins offer an attractive strategy for their potential anti-diabetic effects. In this study, infusions of three different tea types (green, white, and oolong) were investigated for their total phenolic (TPC) and catechins (EGCG, ECG, EGC, and EC) content, and for their α-glucosidase inhibitory activities. We observed that the level of TPC in white tea was significantly higher compared to oolong and green tea, which suggests higher content of EGCG and ECG catechins in fresh young leaves. Our findings showed that the higher content of such catechins in the infusion of white tea well correlated with a strong inhibition of α-glucosidase, and such inhibition was demonstrated to be more effective than the FDA-approved drug acarbose. Then, we computationally explored the molecular requirements for enzyme inhibition, especially for the most active catechins EGCG and ECG, as well as their disposition/stability within the active site.

Objetivo: As infecções relacionadas aos implantes ortopédicos (IRI), que abrange às infecções relacionadas às fraturas (IRF) e às infecções de próteses ortopédicas (IPO), persiste como uma complicação comum após procedimentos cirúrgicos ortopédicos para estabilização de fraturas. Mesmo durante a COVID-19, com a redução dos casos de traumatismo, as taxas de IRI permaneceram elevadas em nossa instituição. O presente estudo teve como objetivo investigar as características epidemiológicas e microbiológicas das IRI em um centro ortopédico terciário brasileiro entre 2020 e 2022. Método: Estudo de coorte retrospectivo em um único centro, envolvendo todos os pacientes submetidos a cirurgia ortopédica para estabilização de fraturas. O diagnóstico de IRF e IPO foi realizado de acordo com os critérios da EBJIS. Foram analisados 402 pacientes que passaram por algum tipo de correção cirúrgica de fratura, sendo incluídos na análise aqueles que desenvolveram IRF e IPO. Os patógenos foram isolados a partir de culturas de tecido peri-implante e fluido de sonicação, e identificados por meio de MALDI-TOF. Resultados: Um total de 65 pacientes com IRI foram incluídos, resultando em uma incidência de infecção de 16,1% (65/402). Os pacientes masculinos representaram 73,8% da amostra, com média de idade de 48,5 ± 18,6 anos. As fraturas fechadas corresponderam a 60% dos casos. Em relação ao mecanismo de trauma, quedas foram responsáveis por 43,1% dos casos, seguidas por acidentes automobilísticos (26,6%). Os sítios de infecção mais frequentemente afetados foram tíbia (26,2%) e quadril (12,3%). Observou-se que 86,2% dos casos correspondiam a IRF e 12,3% a IPO, enquanto infecções após instrumentação da coluna vertebral foram diagnosticadas em 1,5% dos casos. Entre os pacientes com culturas bacterianas positivas, 68,9% apresentaram bactérias gram-positivas e 31% bactérias gram-negativas, sendo o Staphylococcus aureus o patógeno mais prevalente em todos os sítios de infecção. Infecções polimicrobianas (24,1%), principalmente envolvendo bacilos gram-negativos, foram menos comuns do que infecções monomicrobianas (75,8%). Conclusão: Este estudo evidenciou que a incidência de IRI permaneceu alta durante a COVID-19, sendo as infecções monomicrobianas, incluindo espécies de Staphylococcus, as predominantes. A identificação da epidemiologia das vítimas de traumatismo ortopédico e da prevalência microbiológica constitui o primeiro passo em direção ao planejamento terapêutico bem-sucedido.

Introdução: A incidência da infecção relacionada à fratura (IRF) pode variar de 0,4 a 32%, sendo ainda maior em fraturas expostas. Os principais patógenos descritos são os cocos Gram-positivo (CGP), em especial o S. aureus. Entretanto, estudos que avaliam informações epidemiológicas e microbiológicas nas IRF são escassos no Brasil. Este estudo descreve a incidência de IRF e os patógenos associado em um hospital público terciário universitário brasileiro ao longo de 3 anos de coleta de dados. Métodos: Estudo transversal, unicêntrico, com dados coletados entre março de 2020 e março de 2023 de pacientes maiores de 18 anos com fraturas ósseas fechadas e expostas submetidas à fixação ortopédica, exceto próteses articulares. Para o diagnóstico de IRF foi utilizada a definição proposta por METSEMAKERS et al (2017). Resultados: Do total de 462 pacientes incluídos, 71,6% foram do sexo masculino com média de idade de 47,6 anos (DP±20,8). As principais comorbidades foram Hipertensão Arterial Sistêmica (19,3%), tabagismo (19,3%) e etilismo (17,3%). As fraturas expostas foram 25,1% dos casos, sendo a classificação de Gustilo-Anderson do tipo 3-A a mais frequente (69,8%). A incidência global de IRF, em fraturas fechadas, e em fraturas expostas foi de 19,7%, 16,5%, e 29,3% respectivamente. A principal profilaxia cirúrgica foi uma cefalosporina de 1a ou 2a geração (84,6%) associada a um aminoglicosídeo (44,6%) ou isolada (43,1%). Os principais patógenos identificados foram S. aureus (22,1%), K. pneumoniae (11,6%), S. epidermidis (10,5%), demais Staphylococcus coagulase-negativo (10,5%), E. coli (6,3%), P. aeruginosa (5,3%), Streptococcus spp beta-hemolítico (4,2%), outros CGP (9,5%) e outros bacilos Gram-negativo (BGN) (20,0%). A resistência à meticilina foi identificada em 60% das cepas do gênero Staphylococcus e a multidroga resistência (MDR) foi identificada em 53,7% dos BGN. Conclusão: A incidência de IRF global e em fraturas expostas foi elevada, assim como em fraturas fechadas nas quais menores valores são previstos devido à adoção sistemática da profilaxia antimicrobiana cirúrgica. A elevada frequência de BGN (43,2%) demonstrando perfil de MDR (53,7%) associada a uma alta resistência à meticilina do gênero Staphylococcus (60%) apontam para uma mudança no perfil epidemiológico de IRF e sugerem a revisão da profilaxia antimicrobiana em cirurgias ortopédicas com implantes no Brasil.

Introdução: O tratamento ideal da osteomielite ainda é um motivo importante de debate na literatura. Devido à dificuldade de erradicar o biofilme, um dos tratamentos preconizados envolve desbridamento e terapia local com a colocação de espaçadores de polimetilmetacrilato carregado de antibiótico (PMMA+ATB). Há ainda dúvidas se a permanência in situ prolongada do PMMA+ATB no paciente causaria eventos adversos. O objetivo deste estudo foi investigar se a permanência de culturas positivas de fluido de sonicação de PMMA+ATB in situ alteram o desfecho clínico de pacientes com osteomielite crônica. Metodologia: Realizamos estudo preliminar em uma série de casos de 13 pacientes que possuíam diagnóstico de osteomielite em um hospital universitário de São Paulo no período entre 2021 e 2022. Todos receberam tratamento antimicrobiano sistêmico e local com PMMA eluído de Vancomicina e/ou Gentamicina. As culturas de tecido infectado do paciente; o tempo de retenção do PMMA+ATB maior que 4 semanas; e as culturas do fluido de sonicação do PMMA+ATB foram comparados ao sucesso terapêutico destes pacientes avaliados após 6 meses e um ano do tratamento local. O desfecho clínico “sucesso terapêutico” foi definido como ausência de: necessidade de novas terapias antimicrobianas sistêmicas; necessidade de reabordagem cirúrgica; sinais clínicos de osteomielite ativa; e morte relacionada ao procedimento ortopédico. Resultados: As culturas do fluido de sonicação de PMMA+ATB foram positivas em 54% (7/13) dos pacientes. Destes, 100% tiveram sucesso terapêutico após 6 meses. Após um ano, foi possível avaliar o desfecho de 9 pacientes, e 44% (4/9) possuíam cultura de fluido de sonicação de PMMA+ATB positiva. Entretanto, o sucesso terapêutico foi atingido em 78% destes. O tempo de permanência in situ do PMMA+ATB variou de 1,5 a 37 semanas (média= 9 semanas; mediana= 5 semanas). Após 6 meses de seguimento, não houve diferença nas taxas de sucesso de tratamento nos pacientes que mantiveram PMMA+ATB in situ por mais (78%) ou menos (75%) de 4 semanas. Conclusão: A terapia com PMMA+ATB parece ser uma forma efetiva de tratamento de osteomielite crônica. A positividade das culturas em fluido de sonicação de PMMA+ATB após a retirada cirúrgica não parecem estar correlacionadas ao desfecho clínico de sucesso terapêutico após 6 meses e um ano.

Introdução: A infecção relacionada à fratura (IRF) pode ocorrer em taxas elevadas e a maioria causada por Staphylococcus aureus. Contudo, agentes etiológicos podem variar com a localização anatômica e geográfica, mecanismo de trauma e fatores do hospedeiro, sendo importante determinar os patógenos dominantes locais e suas implicações no desfecho do tratamento clínico e cirúrgico. O objetivo deste estudo foi caracterizar o perfil microbiológico nas IRF e associar a falha do tratamento aos patógenos encontrados. Métodos: Estudo observacional, do tipo coorte prospectiva, em pacientes maiores de 18 anos com IRF, conforme critérios de Metsemakers et al (2017), internados entre 2020 e 2023 em hospital terciário de São Paulo. Falha do tratamento de IRF foi definido como necessidade de reoperação ou reinício da terapia antibiótica para o mesmo patógeno, amputação ou óbito. Proporções das variáveis categóricas foram associadas utilizando o teste qui-quadrado ou exato de Fisher. Resultados: Foram avaliados 65 casos de IRF com diagnóstico microbiológico. A média de idade na população foi 44,41 (± 16,7) anos e 46 pacientes eram do sexo masculino (70,8%). Falha de tratamento ocorreu em 27 (41,5%) casos e 6 (9,2%) perderam seguimento após 6 meses de acompanhamento médio. O microrganismo mais frequente nos casos de falha foi o S. aureus (n = 9; 33,3%), K. pneumoniae (n = 6; 22,2%), S. epidermidis (n = 4; 14,8%), E. coli (n = 4; 14,8%) e P. aeruginosa (n = 4; 14,8%). Na análise por grupos houve risco maior de falha nas IRF por bacilos gram-negativo (BGN) não fermentadores [Incidência: 52,9% vs. 42,9%; RR: 1,24 (intervalo de confiança (IC)95% = 0,70-2,18)], S. aureus [Incidência: 50,0% vs. 43,9%; RR:1,14 (IC95% = 0,64-2,03)] e BGN fermentadores [Incidência: 50,0% vs. 45,5%; RR: 1,10 (IC95% = 0,40-3,06)]. Houve menor risco de falha no grupo de Staphylococcus coagulase-negativos [Incidência: 41,2% vs. 47,6%; RR: 0,86 (IC95% = 0,45-1,66)]. Em relação à resistência antimicrobiana, 60% dos Staphylococcus foram resistentes à meticilina (MRSA) e 53,7% dos BGN foram multidrogas resistentes (MDR). Conclusões: Este estudo evidencia altas taxas de falha de tratamento nas IRF, provavelmente associados a bactérias multirresistentes, incluindo o MRSA e BGN-MDR. S. aureus foi a etiologia mais prevalente, contudo, BGNs não fermentadores cursaram com maior risco de falha terapêutica, o que está de acordo a incidência crescente desses patógenos em infecções associadas à assistência à saúde no Brasil.

Introdução: O tratamento antimicrobiano sistêmico empírico ou dirigido por cultura para as infecções ósseas tem classicamente demonstrado altas taxas de falha. Por outro lado, a terapia antibiótica local associada a um biomaterial com o cimento ortopédico ou polimetilmetacrilato (PMMA), tem progressivamente mostrado altas taxas de resolutividade e poucos eventos adversos locais e sistêmicos. Este estudo avalia o desfecho de sobrevida livre de infecção após a terapia antibiótica local no tratamento das osteomielites crônicas e infecções associadas à fratura (IAF). Método: Estudo de série de casos com seguimento ambispectivo para avaliar a taxa de controle de infecção óssea em pacientes com osteomielite crônica cavitaria e IAF que foram tratados com terapia antibiótica local associado à PMMA, e acompanhados no Grupo de Infecções Musculoesqueléticas de um Hospital Universitário Terciário, de abril de 2020 a maio de 2023. Foram excluídos os pacientes com artroplastias infectadas. Resultados: No total, oito pacientes com osteomielite e 13 com IAF foram avaliados, sendo 15 (71%) homens, com média de idade de 42 anos (DP+- 18-72). A comorbidade mais comum foi o tabagismo (23%). Infecção em tíbia e fêmur foram predominantes (90%), seguido de coluna e úmero. Em 20 pacientes (95%) foi usado o PMMA como veículo para o antibiótico e em 1 (5%), biocerâmica. O cimento foi diluído apenas com vancomicina em 15 casos (71%) e em associação com gentamicina em 6 (28%). Dezesseis pacientes (76%) receberam tratamento sistêmico, enquanto 6 (28%) receberam apenas tratamento local. Foram identificados microrganismos em 95% dos casos, sendo metade infecção polimicrobiana. Trinta e sete patógenos foram isolados em culturas ósseas e de fluido de sonicação, 15 (41%) eram Staphylococcus coagulase negativos, 13 Staphylococcus aureus, 4 Bacilos Gram-negativos, 3 Streptococcus spp. e 2 Enterococcus faecalis. O tempo médio de seguimento foi de 9 meses (2 – 19 meses). Três pacientes (15%) tiveram recorrência de sintomas, enquanto 18 (85%) permanecem assintomáticos. Todos os 3 receberam também terapia antimicrobiana sistêmica. Conclusão: O tratamento para osteomielite com terapia antibiótica associado ao PMMA e outros biomateriais se mostrou eficiente como terapia adjuvante. Mais estudos são necessários para padronização de materiais e doses.