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Malt bagasse is a by-product of the brewing industry that has high moisture, making it very unstable and susceptible to fast microbial deterioration. This work evaluated drying kinetic models of malt bagasse during pneumatic transport with air flow at 30, 45 and 60°C and layouts of 4.5 and 7.0 m. The results showed that the decrease of moisture from malt bagasse was favored at higher air temperature due to the higher diffusion coefficient. In the ranges measured, the values of the effective moisture diffusivity and heat transfer coefficient were obtained between 2.05×10−10 to 12.74×10−10 m2/s and 175 to 363 W/(m2 K), respectively. Average energy for liquid diffusion in the malt bagasse drying process was 44.30 kJ/mol. Pneumatic transport with air flow at 60°C and layout of 7.0 m reached rapidly the final moisture of 12% (w.b.), which may reduce transport costs and allow for long periods of stable storage for malt bagasse. The statistical tests results showed that the experimental data presented excellent fit using the modified Henderson-Pabis model, in the temperature range for both layouts.

In Brazil, abortion is legally restricted but highly prevalent. The objective of this study was to obtain data on the opinions of obstetrician-gynaecologists regarding abortion and to verify whether there is consistency between their personal opinion with respect to abortion and their private decision when confronted personally with an unwanted pregnancy or with a request for abortion from a patient or relative. A structured questionnaire was sent to obstetrician-gynaecologists, members of the Brazilian Federation of Gynaecological and Obstetrical Societies (FEBRASGO). A total of 4261 physicians responded, a 30% response rate. Almost a quarter of female physicians and a third of male physicians had had an unwanted pregnancy, and 80% of these were aborted. Even among those for whom religion was very important, almost 70% chose abortion when personally faced with an unwanted pregnancy Twice as many respondents accepted abortion as a solution for themselves or their partners as for their patients. The difference was much smaller only if the physician had personally experienced abortion. Thus, the closer physicians are to the problem of abortion, the greater their understanding that there are circumstances under which abortion is the best or only alternative. We expect the publication of these data to contribute towards liberalisation of the abortion law in Brazil. [ABSTRACT FROM AUTHOR]

To date, studies of the role for epidermal integrin α3β1 in cutaneous wound re-epithelialization have produced conflicting results: wound studies in skin from global α3-null neonatal mice have implicated the integrin in promoting timely wound re-epithelialization, whereas studies in adult mice with constitutive, epidermal-specific α3β1 deletion have not. The objective of this study was to utilize a model of inducible α3β1 deletion in the epidermis to clarify the role of α3β1 in the healing of adult wounds. We utilized the recently developed transgenic K14 Cre-ERT ::α3 flx/flx mice (ie, inducible α3 epidermal knockout), permitting us to delete floxed Itga3 alleles (α3 flx/flx ) from epidermis just prior to wounding with topical treatment of 4-hydroxytamoxifen. This allows for the elucidation of α3β1-dependent wound healing in adult skin, free from compensatory mechanisms that may occur after embryonic deletion of epidermal α3β1 in the widely used constitutive α3β1-knockout mouse. We found that re-epithelializing wound gaps are larger in inducible α3 epidermal knockout mice than in control mice, indicating delayed healing, and that epidermal integrin α3β1 promotes healing of wounds, at least in part by enhancing keratinocyte proliferation. This work provides essential rationale for future studies to investigate integrin α3β1 as a therapeutic target to facilitate wound healing., (© 2024 The Authors.)

Objectives were to assess differences in uterine microbiome associated with clinical cure and pregnancy outcomes in dairy cows treated for metritis. Cows with metritis (reddish-brownish, watery, and fetid vaginal discharge) were paired with cows without metritis based on parity and days postpartum. Uterine contents were collected through transcervical lavage at diagnosis, five days later following antimicrobial therapy (day 5), and at 40 days postpartum. Uterine microbiome was assessed by sequencing the V4 hypervariable region of the 16S rRNA gene. Although alpha-diversity based on Chao1, Shannon, and inverse Simpson indexes at diagnosis did not differ between cows with and without metritis, disease was associated with differences in beta-diversity. Prevalence of Porphyromonas, Bacteroides, and Veillonella was greater in cows with metritis. Streptococcus, Sphingomonas, and Ureaplasma were more prevalent in cows without metritis. Differences in beta-diversity between cows with and without metritis persisted on day 5. Uterine microbiome was not associated with clinical cure. Richness and alpha-diversity, but not beta-diversity, of uterine microbiome 40 days postpartum were associated with metritis and pregnancy. No relationship between uterine microbiome and pregnancy outcomes was observed. Results indicate that factors other than changes in intrauterine bacterial community underlie fertility loss and clinical cure in cows with metritis., (© 2024. The Author(s).)

The development of wound therapy targeting integrins is hampered by inadequate understanding of integrin function in cutaneous wound healing and the wound microenvironment. Following cutaneous injury, keratinocytes migrate to restore the skin barrier, and macrophages aid in debris clearance. Thus, both keratinocytes and macrophages are critical to the coordination of tissue repair. Keratinocyte integrins have been shown to participate in this coordinated effort by regulating secreted factors, some of which crosstalk to distinct cells in the wound microenvironment. Epidermal integrin α3β1 is a receptor for laminin-332 in the cutaneous basement membrane. Here we show that wounds deficient in epidermal α3β1 express less epidermal-derived macrophage colony-stimulating factor 1 (CSF-1), the primary macrophage-stimulating growth factor. α3β1-deficient wounds also have fewer wound-proximal macrophages, suggesting that keratinocyte α3β1 may stimulate wound macrophages through the regulation of CSF-1. Indeed, using a set of immortalized keratinocytes, we demonstrate that keratinocyte-derived CSF-1 supports macrophage growth, and that α3β1 regulates Csf1 expression through Src-dependent stimulation of Yes-associated protein (YAP)-Transcriptional enhanced associate domain (TEAD)-mediated transcription. Consistently, α3β1-deficient wounds in vivo display a substantially reduced number of keratinocytes with YAP-positive nuclei. Overall, our current findings identify a novel role for epidermal integrin α3β1 in regulating the cutaneous wound microenvironment by mediating paracrine crosstalk from keratinocytes to wound macrophages, implicating α3β1 as a potential target of wound therapy., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Aging is associated with nonresolving inflammation and tissue dysfunction. Resolvin D2 (RvD2) is a proresolving ligand that acts through the G-protein-coupled receptor called GPR18. Unbiased RNA sequencing revealed increased Gpr18 expression in macrophages from old mice, and in livers from elderly humans, which was associated with increased steatosis and fibrosis in middle-aged (MA) and old mice. MA mice that lacked GPR18 on myeloid cells had exacerbated steatosis and hepatic fibrosis, which was associated with a decline in Mac2 + macrophages. Treatment of MA mice with RvD2 reduced steatosis and decreased hepatic fibrosis, correlating with increased Mac2 + macrophages, increased monocyte-derived macrophages, and elevated numbers of monocytes in the liver, blood, and bone marrow. RvD2 acted directly on the bone marrow to increase monocyte-macrophage progenitors. A transplantation assay further demonstrated that bone marrow from old mice facilitated hepatic collagen accumulation in young mice. Transient RvD2 treatment to mice transplanted with bone marrow from old mice prevented hepatic collagen accumulation. Together, this study demonstrates that RvD2-GPR18 signaling controls steatosis and fibrosis and provides a mechanistic-based therapy for promoting liver repair in aging., (Copyright © 2023 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.)

Cross-linking has been used as a strategy to improve the mechanical properties of starch films. However, the concentration of the cross-linking agent and the cure time and temperature determine the structure and properties of the modified starch. This article, for the first time, reports the chemorheological study of cross-linked starch films with citric acid (CA) through monitoring the storage modulus as a function of time G'(t). In this study, a CA concentration of 10 phr showed a pronounced increase of G'(t) during the cross-linking of starch, followed by a constant plateau. Analyses of infrared spectroscopy validated the result chemorheological. In addition, the mechanical properties showed a plasticizing effect of the CA at high concentrations. This research demonstrated that chemorheology is a valuable tool in the study of starch cross-linking, which becomes a promising technique to evaluate the cross-linking of other polysaccharides and cross-linking agents., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Objectives were to evaluate differences in the uterine and serum metabolomes associated with metritis in dairy cows. Vaginal discharge was evaluated using a Metricheck device (Simcro) at 5, 7, and 11 d in milk (DIM; herd 1) or 4, 6, 8, 10, and 12 DIM (herd 2). Cows with reddish or brownish, watery, and fetid discharge were diagnosed with metritis (n = 24). Cows with metritis were paired with herdmates without metritis (i.e., clear mucous vaginal discharge or clear lochia with ≤50% of pus) based on DIM and parity (n = 24). Day of metritis diagnosis was considered study d 0. All cows diagnosed with metritis received antimicrobial therapy. The metabolome of uterine lavage collected on d 0 and 5, and serum samples collected on d 0 were evaluated using untargeted gas chromatography time-of-flight mass spectrometry. Normalized data were subjected to multivariate canonical analysis of population using the MultBiplotR and MixOmics packages in R Studio. Univariate analyses including t-test, principal component analyses, partial least squares discriminant analyses, and pathway analyses were conducted using Metaboanalyst. The uterine metabolome differed between cows with and without metritis on d 0. Differences in the uterine metabolome associated with metritis on d 0 were related to the metabolism of butanoate, amino acids (i.e., glycine, serine, threonine, alanine, aspartate, and glutamate), glycolysis and gluconeogenesis, and the tricarboxylic acid cycle. No differences in the serum metabolome were observed between cows diagnosed with metritis and counterparts without metritis on d 0. Similarly, no differences in uterine metabolome were observed between cows with metritis and counterparts not diagnosed with metritis on d 5. These results indicate that the establishment of metritis in dairy cows is associated with local disturbances in amino acid, lipid, and carbohydrate metabolism in the uterus. The lack of differences in the uterine metabolome on d 5 indicates that processes implicated with the disease are reestablished by d 5 after diagnosis and treatment., (The Authors. Published by Elsevier Inc. and Fass Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Patients with cutaneous leishmaniasis (CL) due to Leishmania braziliensis infection have an exacerbated inflammatory response associated with tissue damage and ulcer development. An increase in the rate of patients who fail therapy with pentavalent antimony has been documented. An adjuvant therapy with an anti-inflammatory drug with the potential of Leishmania killing would benefit CL patients. The aim of the present study was to investigate the contribution of peroxisome proliferator-activated receptor-γ (PPAR-γ) activation by pioglitazone in the regulation of the inflammatory response and L. braziliensis killing by monocytes. Pioglitazone is an oral drug used in the treatment of diabetes, and its main mechanism of action is through the activation of PPAR-γ, which is expressed in many cell types of the immune response. We found that activation of PPAR-γ by pioglitazone decreases the inflammatory response in CL patients without affecting L. braziliensis killing by monocytes. Our data suggest that pioglitazone may serve as an adjunctive treatment for CL caused by L. braziliensis ., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Nascimento, Cordeiro, Abreu, Santos, Peixoto, Duarte, Cardoso, de Oliveira, Carvalho and Carvalho.)

Objectives were to evaluate the effect of 2 analogs of PGF 2α (cloprostenol vs. dinoprost) and 2 doses (1 injection vs. 2 injections) on luteolysis, follicle diameter, hormonal concentrations, and time to ovulation in dairy heifers. Holstein heifers were fitted with automated estrus detection devices and had their estrous cycle synchronized using PGF 2α and an intravaginal insert containing progesterone. Heifers detected in estrus were blocked by weight and randomly assigned to 1 of 4 treatments in a 2 × 2 factorial arrangement: cloprostenol on d 7 after estrus (CLOx1; n = 45), cloprostenol on d 7 and 8 after estrus (CLOx2; n = 41), dinoprost on d 7 after estrus (DINx1; n = 43), or dinoprost on d 7 and 8 after estrus (DINx2; n = 44). Treatment with the first injection of PGF 2α was defined as experiment d 0. Area and blood flow of corpus luteum (CL) and diameter of follicles >5 mm were recorded every 12 h from d 0 to estrus and every 6 h thereafter until ovulation. Blood was sampled every 6 h from d 0 until ovulation. Heifers treated with cloprostenol had shorter interval to luteolysis (± SEM; CLOx1 = 23.5 ± 2.2, CLOx2 = 22.9 ± 2.2, DINx1 = 32.6 ± 2.7, DINx2 = 26.4 ± 2.1 h); however, time to ovulation was not affected by treatment. A smaller proportion of heifers treated with a single injection of PGF 2α underwent luteolysis compared with heifers treated with 2 injections (CLOx1 = 84.6 ± 6.2, CLOx2 = 100.0 ± 0.0, DINx1 = 59.7 ± 9.8, DINx2 = 96.3 ± 2.7%). Proportion of heifers that ovulated was smaller for DINx1 compared with other treatments (CLOx1 = 88.8 ± 5.1, CLOx2 = 100.0 ± 0.0, DINx1 = 55.2 ± 9.7, DINx2 = 94.4 ± 3.4%). Ovulatory follicle diameter was larger for DINx1 (18.2 ± 2.7 mm) compared with DINx2 (17.4 ± 2.7 mm), whereas dose did not affect the diameter of the ovulatory follicle in heifers treated with cloprostenol (CLOx1 = 17.6 ± 2.7 vs. CLOx2 = 17.8 ± 2.8 mm). Among heifers that underwent luteolysis, progesterone concentrations from 18 to 36 h after treatment were lesser in heifers treated with cloprostenol compared with those treated with dinoprost. Type of PGF 2α did not affect progesterone concentrations past 36 h from treatment; however, heifers treated with 2 PGF 2α injections had lesser progesterone concentrations and CL blood flow from 36 to 72 h after treatment compared with heifers that received a single PGF 2α injection., (© 2022, The Authors. Published by Elsevier Inc. and Fass Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Background: Enzyme-linked immunosorbent assays (ELISA) are generally the chosen test for Chagas disease (CD) diagnosis; however, its performance depends on the antigen preparation adsorbed to the solid phase, which may lead to false-positive results and cross-reactions. The use of chimeric recombinant antigens can overcome this limitation. Four chimeric antigens from Trypanosoma cruzi (IBMP-8.1, IBMP-8.2, IBMP-8.3 and IBMP-8.4) were developed and evaluated in phase I, II and III studies using indirect ELISA as diagnostic platform. However, peroxidase-labeled secondary anti-human IgG antibody, which is employed in indirect ELISAs, limits its use for the detection of species-specific and class-specific antibodies. To overcome this limitation, peroxidase-labeled antigens can be utilized, diagnosing both acute or chronic infection, in a species and immunoglobulin class-independent manner, through the use of a double-antigen sandwich ELISA (DAgS-ELISA). We aimed to evaluate and validate the diagnostic performance of the chimeric antigens IBMP-8.1, IBMP-8.2, IBMP-8.3 and IBMP-8.4 in the DAgS-ELISA platform., Methodology/principal Findings: DAgS-ELISA was optimized by checkerboard titration. In phase I study, 207 positive and 205 negative samples were evaluated. Cross-reactivity to other infections was also assessed using 68 samples. The selected conditions for the tests utilized 25 ng of antigen per well and the conjugate diluted at 1:2,000 for all molecules. In the phase I study, the areas under the curve of IBMP-8.1, IBMP-8.2, IBMP-8.3 and IBMP-8.4 were 98.7%, 99.5%, 98.6% and 98.8%, respectively. Among the positive samples, IBMP-8.1 antigen classified 53 (25.6%) as false negative, IBMP-8.2, 27 (13%), IBMP-8.3, 24 (11.6%) and IBMP-8.4, 43 (20.8%), giving sensitivities of 74.4%, 87%, 88.4% and 79.2%, respectively. The only antigen that did not reach 100% specificity was IBMP-8.3, with 96.6%. IBMP-8.3 was also the only molecule to show cross-reactivity with HTLV., Conclusions/significance: DAgS-ELISA is a promising tool for immunodiagnosis, and despite the high AUC values, the performance of this assay was different from the values obtained by our group when using these antigens in the indirect ELISA, for this reason, improvements are being considered to increase the sensitivity of the DAgS-ELISA., Competing Interests: The authors have declared that no competing interests exist.

The traditional solvent casting method for preparing chitosan-based materials has limited productivity relative to the productivity of thermomechanical processing. Consequently, the thermomechanical processing technique was evaluated as a way to increase chitosan production. The role of citric acid (CA) as a destructuring and crosslinking agent during such processing was examined. SEM images revealed robust fibers that were associated with a superior mechanical strength (145%), which were produced after thermomechanical processing of chitosan in the presence of CA. Based on articles reviewed, this is the first time that this structure has been closely observed in the microstructure of chitosan-based materials. FTIR and XRD characterization showed the occurrence of chemical crosslinking and the successful destructuring of chitosan powder by CA during processing. Compared to acetic acid, the use of CA led to the development of materials with a homogeneous morphology and good physicochemical and mechanical properties that are suitable for biomedical applications., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

A review of archival cases at Northwest ZooPath from 1995-2018 identified 16/96 (17%; eight females, eight males) lesser kudus ( Tragelaphus imberbis ) with chronic pancreatic disease (CPD) from three institutions, all of which originated from an initial founder stock of 12 animals. Ages at time of death or euthanasia ranged from 2 to 132 mo (average age = 69 mo). All cases had varying degrees of pancreatic acinar cell depletion, ductular hyperplasia, and fibrosis. Serum fructosamine, glucose, insulin, and insulin to glucose ratio collected close to time of death from 13 affected animals were not significantly different from controls ( n = 19). Of these analytes, receiver operating characteristic analysis identified fructosamine as the best-performing analyte with an area under the curve 0.671 (95% confidence interval = 0.480-0.828; sensitivity = 58.3%, specificity = 84.2%; cutoff point >352 µmol/L) in the diagnosis of CPD. With a 15% prevalence, there was a positive predictive value of 41% and a negative predictive value of 92%, indicating that the probability of false positives is high, but of false negatives is low. An etiologic agent was not identified by histology ( n = 16), transmission electron microscopy ( n = 1), or enterovirus PCR ( n = 2). Serum zinc and hepatic heavy metal analyses were judged to be within normal limits. Chronic pancreatic disease is considered an important cause of morbidity and mortality in the lesser kudu; serum chemistry analysis warrants further investigation in its use for diagnosis. The etiopathogenesis is not understood, but the absence of obvious causes, the occurrence also in very young animals, and the inbred lineage of lesser kudus in the United States suggest a genetic basis for this disease.

Our objective was to evaluate the association between days in the prepartum group (DPG) with performance and survival in Holstein cows. Data from 18,657 Holstein cow-lactations (6,993 nulliparous and 9,390 parous prepartum) were collected. Cows with a gestation length shorter than 256 d (n = 267) or longer than 296 d (n = 131) and cows that spent 0 DPG (n = 238) were removed, resulting in 18,021 cow-lactations. Data were collected for the first 300 d postpartum, and responses included milk yield, incidence of diseases by 90 d postpartum, reproduction, and survival. Days in the prepartum group were analyzed as a continuous variable, and regression coefficients were used to estimate the responses when cows spent 7, 28, or 42 DPG, representing cows with a short, moderate, or an extended time in the prepartum group, respectively. An interaction between DPG as a quadratic covariate and parity-diet was observed for milk yield by 300 d postpartum. Means were 9,331; 9,665; and 9,261 kg for 7, 28, or 42 DPG, respectively, in nulliparous cows, and 9,886; 10,939; and 10,117 kg for 7, 28, or 42 DPG, respectively, in parous cows. Also, the interaction between DPG and parity-diet affected retained placenta, metritis, mastitis, and morbidity. Morbidity affected 49.5, 52.9, and 59.5% of nulliparous and 49.7, 26.5, and 47.4% of parous cows that spent 7, 28, or 42 DPG, respectively. A linear association between DPG and pregnancy at first artificial insemination was observed with estimates of 37.0, 32.6, and 29.8% for 7, 28, and 42 DPG, respectively. On the other hand, a quadratic association was observed between DPG and the proportion of pregnant cows at 300 d postpartum, and estimates for 7, 28, and 42 DPG were, respectively, 71.7, 73.5, and 58.8%. A quadratic relationship was also observed for DPG and removal from the herd by 300 d postpartum, and estimates were 25.2, 22.9, and 34.4% for 7, 28, or 42 DPG, respectively. Associations between DPG with production, health, reproduction, and survival were detected, and they varied with parity-diet group. For several responses evaluated, a quadratic association was observed, which suggested that there was an optimal period for cows to spend in the prepartum group, and reduced or extended number of days were detrimental to performance., (Copyright © 2021 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Objective:  To find out which was the opinion of residents in obstetrics and gynecology about the advantages and disadvantages of medical abortion as compared with surgical procedures., Method:  Cross-sectional multicenter study among residents in obstetrics and gynecology from 21 maternity hospitals located in 4 different geographical regions of Brazil, using a self-responded questionnaire with 31 questions related to their opinion and experience on providing abortion services., Results:  Most residents agreed that "being less invasive" (94.7%), "does not require anesthesia" (89.7%), "can be accompanied during the process" (89.1%), "prevents physical trauma" (84.4%) were the main advantages of medical abortion., Conclusion:  Residents perceived both clinical and personal issues as advantages of medical abortion., Competing Interests: The authors have no conflict of interests to declare., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Medical or drug-induced abortion has been proven as an effective means for termination of pregnancy. However, training of providers in the use of misoprostol has been limited. The current article aims to identify the degree of knowledge on medical abortion among Brazilian medical residents in Gynecology and Obstetrics. A multicenter cross-sectional study was performed with residents regularly enrolled in residency programs in Gynecology and Obstetrics in 21 teaching hospitals. A self-responded questionnaire was used. Correct responses to each of the alternatives were identified, and a binary response variable (≥ P70, < P70) was defined by the 70th percentile of the number of questions on misoprostol. Four hundred and seven medical residents returned the questionnaire, of which 404 were completed and three were blank. The majority (56.3%) of the residents were 27 years or younger, females (81.1%), and single or not living with a partner (70%). Two-thirds (68.2%) were in the first or second year of residency. Only 40.8% of the participants answered 70% or more of the questions correctly. In the multivariate analysis, enrollment in the third year of residency or greater (OR = 2.18; 95%CI: 1.350-3.535) and having participated in treatment of a woman with induced or probably induced abortion (OR = 4.12; 95%CI: 1.761-9.621) were associated with better knowledge on the subject. Among Brazilian medical residents in Gynecology and Obstetrics, knowledge on medical abortion is very limited and poses an obstacle to proper care in cases of legal termination of pregnancy.

Insect chemical ecology (ICE) evolved as a discipline concerned with plant-insect interactions, and also with a strong focus on intraspecific pheromone-mediated communication. Progress in this field has rendered a more complete picture of how insects exploit chemical information in their surroundings in order to survive and navigate their world successfully. Simultaneously, this progress has prompted new research questions about the evolution of insect chemosensation and related ecological adaptations, molecular mechanisms that mediate commonly observed behaviors, and the consequences of chemically mediated interactions in different ecosystems. Themed meetings, workshops, and summer schools are ideal platforms for discussing scientific advancements as well as identifying gaps and challenges within the discipline. From the 11th to the 22nd of June 2018, the 11th annual PhD course in ICE was held at the Swedish University of Agricultural Sciences (SLU) Alnarp, Sweden. The course was made up of 35 student participants from 22 nationalities (Fig. 1a) as well as 32 lecturers. Lectures and laboratory demonstrations were supported by literature seminars, and four broad research areas were covered: (1) multitrophic interactions and plant defenses, (2) chemical communication focusing on odor sensing, processing, and behavior, (3) disease vectors, and (4) applied aspects of basic ICE research in agriculture. This particular article contains a summary and brief synthesis of these main emergent themes and discussions from the ICE 2018 course. In addition, we also provide suggestions on teaching the next generation of ICE scientists, especially during unprecedented global situations., Competing Interests: Conflict of interestThe authors declare that they have no conflicts of interest., (© The Author(s) 2020.)

Purpose: To investigate the opinions of Brazilian medical residents in Obstetrics and Gynaecology on abortion legislation according to their personal beliefs. Material and methods: A multicentre cross-sectional study. Residents at 21 university teaching hospitals completed a self-report questionnaire on their opinions in abstract terms, and about punishing women who abort in general and women they know. Results: In abstract terms, 8% favoured allowing abortion under any circumstances (fully liberal); 36% under socioeconomic or psychological constraints (broadly liberal); 75.3% opposed punishing a woman who has aborted (liberal in general practice); and 90.2% opposed punishing women they knew personally (liberal in personal practice). Not having a stable partner and not being influenced by religion were factors associated with liberal opinions. In personal practice, however, 80% of those who are influenced by religion were liberal. The percentage of respondents whose opinions were liberal was significantly greater among those who believed that abortion rates would remain the same or decrease following liberalisation. Conclusions: Judgements regarding the penalisation of women who abort are strongly influenced by how close the respondent is to the problem. Accurate information on abortion needs to be provided. Although about one third of the respondents were broadly liberal, the majority oppose punishment.

For 15 years, from 2001, we began to apply Heberprot-P®, an injectable Epidermal Growth Factor (0.75 μg) created in the Center of Biotechnology, in Havana, Cuba. More than 159,000 patients were treated around the world, from 25 countries, with, with only 9-11% high-level amputations. In this paper, we discuss our experience in the treatment of the most complex diabetic foot ulcers cases for the last 15 years.

Introduction: Feeding difficulties in children with cleft lip and palate (CLP) are frequent and appear at birth due to impairment of sucking and swallowing functions. The use of appropriate feeding methods for the different types of cleft and the period of the child's life is of utmost importance for their full development., Objective: Review studies comparing feeding methods for children with CLP, pre- and postoperatively., Methods: The search covered the period between January 1990 and August 2015 in the PubMed, LILACS, SciELO, and Google Scholar databases using the terms: cleft lip or cleft palate and feeding methods or breastfeeding or swallowing disorders and their synonyms. This systematic review was recorded in PROSPERO under number CRD42014015011. Publications that compared feeding methods and published in Portuguese, English, and Spanish were included in the review. Studies with associated syndromes, orthopedic methods, or comparing surgical techniques were not included., Results: The three reviewed studies on the period prior to surgical repair showed better feeding performance with three different methods: squeezable bottle, syringe, and paladai bottle. Only one study addressed the postoperative period of cleft lip and/or palate repair, with positive results for the feeding method with suction. Likewise, the post-lip repair studies showed better results with suction methods. After palatoplasty, two studies showed better performance with alternative feeding routes, one study with suction method, and one study that compared methods with no suction showed better results with spoon., Conclusion: The studies show that prior to surgical repair, the use of alternative methods can be beneficial. In the postoperative period following lip repair, methods with suction are more beneficial. However, in the postoperative period of palatoplasty, there are divergences of opinion regarding the most appropriate feeding methods., (Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.)

Coral reefs are at risk due to events associated with human activities, which have resulted in the increasing occurrence of coral diseases. Corals live in symbiotic relationships with different microorganisms, such as cyanobacteria, a very important group. Members of the phylum Cyanobacteria are found in great abundance in the marine environment and may play an essential role in keeping corals healthy but may also be pathogenic. Furthermore, some studies are showing a rise in cyanobacterial abundance in coral reefs as a result of climate change. The current study aimed to improve our understanding of the relationship between cyanobacteria and coral health. Our results revealed that the cyanobacterial genus GPI (Anabaena) is a possible opportunistic pathogen of the coral species Millepora alcicornis in the South Atlantic Ocean. Furthermore, the bacterial and microeukaryotic profile of healthy, diseased, and post-disease (skeletal) regions of affected coral indicated that a microbial consortium composed of Anabaena sp., Prosthecochloris sp., and microeukaryotes could be involved in this pathogenicity or could be taking advantage of the diseased state.

Objectives: The aim of the study was to evaluate the association between physicians' understanding of the mechanism of action of the emergency contraceptive pill (ECP), their personal use of it, and their practice in informing their patients about the method and in prescribing it., Methods: The study was carried out in a sample of 3337 obstetrician-gynaecologists who responded to a mailed questionnaire. Bivariate analysis was used to test the association between physicians' personal use of the ECP, their understanding of its mechanism of action, and their practice in informing their patients about the method and in prescribing it. Multiple Poisson regression analysis was carried out to identify variables independently associated with the two dependent variables., Results: Multiple regression analysis showed that the percentage of physicians who had informed their patients about the ECP was significantly lower among those who had needed it themselves but had not used it and among those living in the northeast of Brazil. A significantly higher percentage of female than male physicians had provided information on the ECP. The percentage of physicians who had prescribed the ECP was significantly lower among those who had needed it themselves but had not used it and among those who believed that it caused a mini-abortion. The proportion of physicians who had ever-prescribed the ECP was greater among those who worked exclusively in private practice and among those who worked in a state capital., Conclusions: The misconception that emergency contraception could cause a mini-abortion was associated with its denial to potential users, while physicians' personal experience of needing to use it favoured the likelihood of their informing potential users about it and prescribing it.

Several anthropogenic factors, including contamination by oil spills, constitute a threat to coral reef health. Current methodologies to remediate polluted marine environments are based on the use of chemical dispersants; however, these can be toxic to the coral holobiont. In this study, a probiotic bacterial consortium was produced from the coral Mussismilia harttii and was trained to degrade water-soluble oil fractions (WSFs). Additionally, we assessed the effect of WSFs on the health of M. harttii in tanks and evaluated the bacterial consortium as a bioremediation agent. The consortium was responsible for the highly efficient degradation of petroleum hydrocarbons, and it minimised the effects of WSFs on coral health, as indicated by raised photosynthetic efficiencies. Moreover, the impact of WSFs on the coral microbiome was diminished by the introduced bacterial consortium. Following introduction, the bacterial consortium thus had a dual function, i.e promoting oil WSF degradation and improving coral health with its probiotic features.

Objective: To evaluate sociodemographic factors associated with induced abortion., Methods: As part of a cross-sectional, descriptive study, 15 800 civil servants from Campinas, Brazil, were invited to complete a self-administered questionnaire about absolutely unwanted pregnancies in January 2010. Bivariate analysis and multivariate Poisson regression analysis were used to explore the associations between induced abortion and sociodemographic characteristics., Results: Overall, 1660 questionnaires were returned. Unwanted pregnancy was reported by 296 (17.8%) respondents, of whom 165 (55.7%) resorted to abortion. Multiple regression analysis showed that college education was the only variable associated with an increased chance of abortion. Among 157 participants who answered questions about the abortion procedure, 97 (61.8%) reported that it had been performed by a physician. Following abortion, 35 (22.9%) of 153 reported that medical care was required and 26 (16.6%) of 157 reported hospitalization, principally those with a lower level of education and those whose abortion had been performed by a nonphysician., Conclusion: Compared with women with a college education, those with a lower education level were less likely to terminate an absolutely unwanted pregnancy and to have an abortion performed by a physician, and they were more likely to have complications. These findings confirm the social inequalities associated with abortion in Brazil., (Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

The formation of cholesterol gallstones is a very complex and polygenic disorder that involves an alteration of the secretion of bile lipids, cholesterol crystallization, important immunological reactions in the gallbladder tissue, formation of biliary sludge composed of mucin, and inadequate gallbladder motility. The search for a therapeutic target is oriented towards decreasing bile secretion and intestinal absorption of cholesterol, in which Niemann-Pick C1L1 (NPC1L1) proteins play an important role. In basic and clinical studies, regulating the expression of these proteins can reduce intestinal, liver, plasma and bile cholesterol levels, a therapeutic effect that would be useful not only for treating the disease, but to prevent it, given the large quantity of risk factors. We discuss these effects in this review and propose NPC1L1 proteins as future therapeutic targets of cholesterol gallstones disease., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Objective: To investigate knowledge of HPV and HPV vaccines in men and women, users of the Brazilian Unified Health System, and the intention to get themselves and their teenage children vaccinated., Methods: A descriptive, cross-sectional study with 286 women (18-49 years old) and 252 men (18-60 years old), users of five primary health units and two polyclinics in Campinas, SP, Southeastern Brazil, was carried out. Participants were interviewed in 2011 using a structured questionnaire. Bivariate and Poisson regression analysis were performed to identify variables associated with knowledge of HPV and HPV vaccines, and participants vaccination intentions., Results: Almost 40.0% of the participants reported having heard of HPV and 28.9% mentioned adequate information. The main information source was the media (41.7%). Only 8.6% of the participants had heard of the HPV vaccines. Once the participants were informed of the existence of HPV vaccines about 94% of them said they would get vaccinated and/or vaccinate their teenage children, if the vaccines were available in the public health system. Schooling of over 8 years and being female were the variables independently associated with having heard of HPV, the vaccines and having adequate knowledge of the virus. Advanced age was associated with having heard of HPV vaccines. There were no variables associated with the vaccination intentions., Conclusions: These results reinforce the need for educational activities that provide the population with adequate information on HPV and preventive measures.

Conscientious objection is a legitimate right of physicians to reject the practice of actions that violate their ethical or moral principles. The application of that principle is being used in many countries as a justification to deny safe abortion care to women who have the legal right to have access to safe termination of pregnancy. The problem is that, often, this concept is abused by physicians who camouflage under the guise of conscientious objection their fear of experiencing discrimination and social stigma if they perform legal abortions. These colleagues seem to ignore the ethical principle that the primary conscientious duty of OB/GYNs is-at all times-to treat, or provide benefit and prevent harm to, the patients for whose care they are responsible. Any conscientious objection to treating a patient is secondary to this primary duty. One of the jobs of the FIGO Working Group for the Prevention of Unsafe Abortion is to change this paradigm and make our colleagues proud of providing legal abortion services that protect women's life and health, and concerned about disrespecting the human rights of women and professional ethical principles., (Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Unsafe abortions remain a major public health problem in countries with very restrictive abortion laws. In Brazil, parliamentarians - who have the power to change the law - are influenced by "public opinion", often obtained through surveys and opinion polls. This paper presents the findings from two studies. One was carried out in February-December 2010 among 1,660 public servants and the other in February-July 2011 with 874 medical students from three medical schools, both in São Paulo State, Brazil. Both groups of respondents were asked two sets of questions to obtain their opinion about abortion: 1) under which circumstances abortion should be permitted by law, and 2) whether or not women in general and women they knew who had had an abortion should be punished with prison, as Brazilian law mandates. The differences in their answers were enormous: the majority of respondents were against putting women who have had abortions in prison. Almost 60% of civil servants and 25% of medical students knew at least one woman who had had an illegal abortion; 85% of medical students and 83% of civil servants thought this person(s) should not be jailed. Brazilian parliamentarians who are currently reviewing a reform in the Penal Code need to have this information urgently., (Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.)

Objective: To assess the knowledge of Brazilian medical students regarding medical abortion (MA) and the use of misoprostol for MA, and to investigate factors influencing their knowledge., Methods: All students from 3 medical schools in São Paulo State were invited to complete a pretested structured questionnaire with precoded response categories. A set of 12 statements on the use and effects of misoprostol for MA assessed their level of knowledge. Of about 1260 students invited to participate in the study, 874 completed the questionnaire, yielding a response rate of 69%. The χ(2) test was used for the bivariate analysis, which was followed by multiple regression analysis., Results: Although all students in their final year of medical school had heard of misoprostol for termination of pregnancy, and 88% reported having heard how to use it, only 8% showed satisfactory knowledge of its use and effects. Academic level was the only factor associated with the indicators of knowledge investigated., Conclusion: The very poor knowledge of misoprostol use for MA demonstrated by the medical students surveyed at 3 medical schools makes the review and updating of the curriculum urgently necessary., (Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Objective: To estimate the prevalence of violence in women who are primary healthcare users and to verify if these situations were detected and how they were tackled by these services' professionals., Methods: Descriptive, cross-sectional study carried out with 14 municipal women's health coordinators, 2,379 women who are users of primary healthcare units, 75 managers and 375 professionals, in 15 municipalities of the State of São Paulo (Southeastern Brazil), between August 2008 and May 2009. Data were collected through structured questionnaires and a descriptive analysis was conducted., Results: A specific protocol for assisting women in situations of violence was mentioned in five municipalities. The majority (83%) of the coordinators reported that situations of violence among female users were detected, although 74% said this was not routinely investigated, which was confirmed by 72.3% of the professionals. Among the women, 76.5% reported having experienced some type of violence throughout their lives, and 56.4% said that an intimate partner was the perpetrator of that violence; almost 30% reported at least one episode in the 12 months prior to the interview; 6.5% reported looking for help at a Primary Healthcare Unit., Conclusions: A relevant proportion of users experienced violence in their daily routine, mainly perpetrated by an intimate partner. Most of the women were neither identified nor approached in these services and did not receive help. Although health managers and professionals realized the magnitude of the problem, they did not consider that primary care was prepared to assist these women. The study showed that there is no intersectoral care network to assist women in situation of violence.

Objective: To analyze the opinion of judges and prosecutors concerning Brazilian abortion law and situations in which the abortion should be allowed., Methods: A cross-sectional study was performed with 1,493 judges and 2,614 prosecutors in Brazil between 2005 and 2006. Participants completed a structured questionnaire approaching sociodemographic characteristics, opinions about abortion law, and circumstances in which abortion is considered lawful. Bivariate and multivariate analyses of data were carried out through Poisson regression., Results: The majority of participants (78%) found that the circumstances in which abortion is considered lawful should be broadened, or even that abortion should not be criminalized. The highest rates of pro-abortion opinions resulted from: risk to the life of the mother (84%), anencephaly (83%), severe congenital malformation of fetus (82%), and pregnancy resulting from rape (82%). Variables related to religion were strongly associated to the opinion of participants., Conclusions: There is a trend in considering the need of changing the current abortion law, in the sense of widening the circumstances in which abortion is considered lawful, or even toward decriminalizing abortion, regardless of the circumstances in which it takes place.

This 24-year-old soldier had a history of polytrauma caused by firearm missiles of a fragmentation weapon. He was referred to the Hospital Militar Central, where multiple shrapnel wounds in the head, face, thorax, and extremities were found. A brain abscess was documented and drained, and a culture grew a multidrug-resistant Acinetobacter baumannii. An appropriate antibiotic treatment was started but did not lead to a good response, and the patient died. The clinical course of the illness is presented, as is its treatment and the role of A baumannii as an etiological agent of a brain abscess. To the authors' knowledge, there have been no reported cases in the worldwide literature of brain abscess by this infectious agent.

This paper presents the perceptions of 250 women who requested contraceptive methods (CM) at a public health clinic in relation to their freedom of choice and the role of an educational activity and consultation in this degree of freedom. Satisfaction with the chosen method and continuation after 6 months were also studied. Nearly all the women (99.6%) had already chosen a CM when they came to the clinic, and 90.0% left the clinic with the method; 81.9% reported that they felt very free to choose the method, and 60.0% felt that the educational activity and consultation had improved their degree of freedom. Six months later, 87.3% were using the same CM they had chosen. The proportion of women who changed the method and the proportion of those who felt they had not received sufficient information about the CM when they initiated use were significantly higher among women who reported any dissatisfaction with that method. The educational activity and consultation legitimated the women's choices (which they had already made before attending the health clinic) on the basis of such supplementary sources of information. This fact appears to have contributed to the women's feeling that they had sufficient freedom of choice.

Objective: To investigate factors related to the decision of exclusive breastfeeding, and the planned and the actual duration among working women with free daycare available at workplace., Methods: A qualitative study was conducted comparing a group of 15 women exclusively breastfeeding their babies with a similar group of women whose babies were already being fed with other food besides maternal milk at the time they started attending a daycare center. Semi-structured interviews and focus groups were carried out for data collection., Results: The factors related to the decision of breastfeeding and maintaining it when women went back to work were: the desire to breastfeed based on the importance women of both groups as well as their husbands and significant others attributed to it. The duration of exclusive breastfeeding was mainly associated to the baby's pediatrician counseling, which differed in each group., Conclusions: The availability of free daycare center at the work place seems an important aspect to breastfeeding maintenance after women go back to work, especially regarding exclusive breastfeeding. The duration of exclusive breastfeeding was related to the information received before and during pregnancy, and also in the postpartum. Women who have exclusively breastfed for almost six months believed the longer they breastfeed the better to their babies' health, while other women believed that three months of exclusive breastfeeding would be enough.

Objective: An analysis of secondary data was carried out to evaluate the knowledge adequacy on contraceptives and its association with socioeconomic and demographic characteristics., Methods: The sample consisted of 472 women from the city of Campinas, state of São Paulo, Brazil. Chi-square test was used to evaluate differences among variables and logistic regression was performed to identify independent variables associated with knowledge adequacy (evaluated through a score)., Results: Of the total, 47.6% women reached a score higher than six, which was classified as an adequate knowledge on contraceptives. Higher schooling and better socioeconomic status were associated to higher scores of knowledge., Conclusions: The results show that it is necessary to improve women's education in general, and on contraceptive methods specifically. In addition, professionals working in public health services should be capacitated to provide contraceptives as well as adequate information on contraceptive methods.

This article compares sterilized and non-sterilized women in relation to socio-demographic characteristics, reproductive history, and cohabitation status. Women from 30 to 49 years of age and residing in Campinas, São Paulo State, Brazil, were interviewed with a pre-tested and structured questionnaire: 236 women sterilized at least five years before the interview and 236 non-sterilized women. The sterilized women were significantly more likely to be married or cohabiting, to be younger when they began cohabiting, and to have been in the union longer than the non-sterilized women. They also began childbearing at an earlier age and had a history of more pregnancies and more live births than non-sterilized women. Factors associated with a history of 3 or more live births at the time of the interview were surgical sterilization, younger age at first childbirth, older age at the interview, recognition of fewer contraceptive methods, and lower per capita income. The article concludes that sterilization generally appears to be the consequence of higher fertility in a group of women who initiate childbearing early in life, although its role in preventing these women from having even larger families may also have a demographic impact.

This study aimed to evaluate male participation in the use of contraceptive methods and to identify relevant variables. A secondary data analysis was conducted, and the sample size was estimated at 175 men using contraceptives methods that require male participation. The study used the qui-square test to evaluate differences between groups, as well as multiple logistic regression analysis. Some 38% of interviewees used some birth control method that required male participation. Higher level of schooling was associated with the use of some form of contraception requiring male participation, i.e., condom use or vasectomy. Considering the sample's characteristics, the study concluded that it is possible for important changes to take place in Brazilian society with regard to the male perspective on contraception. For these changes to be possible it is necessary to invest in education for both men and women, shown to be an important factor for a balance in gender relations.

Objective: To analyze the perspective on induced abortion of men of a university community living in legal or consensual wedlock., Methods: A descriptive cross-sectional study was carried out and 361 members of different categories of an university were interviewed. Chi-square test was used to assess the association between dependent and independent variables., Results: Fifth-three percent of the participants acknowledged that women have the right to end pregnancy. Men were more favorable to abortion when there is a risk to woman's life (85%); rape-related pregnancy (80%); and fetal anomalies (75%). Higher schooling of both men and their partners and the interviewees' position (teacher/student) were associated to a positive attitude towards abortion., Conclusions: Men tended to be more prone to abortion in legally and/or socially accepted instances. Better education of both men and their partners was relevant to determine their attitude towards abortion.

Objectives: The opinions of Brazilian women regarding vaginal delivery and cesarean sections was studied., Methods: Six hundred and fifty-six women who had given birth in seven hospitals in São Paulo and Pernambuco, using the Public Health Service, were interviewed. The opinions of women who had delivered only by cesarean section was compared with those of women who had had at least one vaginal delivery., Results: Significantly more women who had experienced at least one vaginal delivery considered this to be the best way of giving birth (90.4% vs. 75.9% among C-section-only women). Similar proportions in both groups (45.5% and 42.8%) stated that vaginal labor is better because it causes less pain and suffering for the woman. Significantly more women who had experienced a vaginal labor (47.1% vs. 30.3%) reported that it had no disadvantage. More women who had only had cesarean sections referred not having contractions/pain as an advantage of this method (56.7% vs. 41.7%)., Conclusions: Apparently, pain and women's perception of pain were the characteristics which differentiated women with history of vaginal delivery from those with cesarean sections in the sample studied. However, the opinion that vaginal delivery is better than cesarean section was expressed independently of the recognition that pain could be its main disadvantage., (© 2001 International Federation of Gynecology and Obstetrics.)

A multi-centered qualitative study was conducted in Brazil, Chile, and Mexico to assess the acceptability of emergency contraception both among potential users and possible providers, authorities, and opinion-makers, and to identify (according to participants' perceptions) factors facilitating or hindering the method's use and the most appropriate strategies to disseminate information and provide the method. Data were collected through semi-structured interviews, group interviews, and discussion groups, which were tape-recorded and transcribed. A thematic analysis of this material was conducted. Acceptability of emergency contraception was high among participants, who also felt that there were no barriers towards its acceptance by the population. Participants felt that the method's acceptability would be greater if it were included in reproductive health programs, emphasizing its prescription for emergency situations. Participants highlighted that strategic components in Brazil would be training of providers and inclusion of the method in family planning services.

Historically, family planning programs have targeted women almost exclusively. More recently it has become clear that men have a strong influence on their partners' use of contraception, either by opposing the use of any or one specific method, or by deciding that a woman has to either use a given method or be sterilized. In this context, our study aimed to evaluate the male perspective on the role of gender in the decision to use contraceptive methods and to have and raise children. The sample consisted of 776 males from a university in the State of São Paulo: 467 graduate students, 314 employees, and 129 teachers. A structured, previously tested questionnaire was used for the interviews. Data analysis is currently under way. The least familiar contraceptive methods were Billings (29.9%), injectables (35.4%), and jellies (57.8%). Some 80% of the interviewees mentioned other methods. The proportion of men who denied knowledge of any contraceptive method whatsoever was 1.6%. Our findings are similar to those of other authors.