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Understanding the entropy production of systems strongly coupled to thermal baths is a core problem of both quantum thermodynamics and mesoscopic physics. While many techniques exist to accurately study entropy production in such systems, they typically require a microscopic description of the baths, which can become numerically intractable to study for large systems. Alternatively an open-systems approach can be employed with all the nuances associated with various levels of approximation. Recently, the mesoscopic leads approach has emerged as a powerful method for studying such quantum systems strongly coupled to multiple thermal baths. In this method, a set of discretized lead modes, each locally damped, provide a Markovian embedding. Here we show that this method proves extremely useful to describe entropy production of a strongly coupled open quantum system. We show numerically, for both noninteracting and interacting setups, that a system coupled to a single bath exhibits a thermal fixed point at the level of the embedding. This allows us to use various results from the thermodynamics of quantum dynamical semigroups to infer the nonequilibrium thermodynamics of the strongly coupled, non-Markovian central systems. In particular, we show that the entropy production in the transient regime recovers the well-established microscopic definitions of entropy production with a correction that can be computed explicitly for both the single- and multiple-lead cases.

Aim: To evaluate antifungal potential of 5,6,7,8-tetrahydroimidazo[1,2- a ]pyrazine hybrids based on thiosemicarbazones and thiazolidinediones against pathogenic Sporothrix species. Methods: Antifungal activity of nine compounds were assessed by broth microdilution. Interactions between active compounds and itraconazole were evaluated by the checkerboard assay using non-wild-type isolates. Cytotoxicity of the compounds was determined. Results: Four C-3 substituted analogs showed antifungal activity, unrelated to thiosemicarbazone or thiazolidinedione functions. Synergistic interactions between the four compounds and itraconazole, and low toxicity on mouse fibroblast cells were observed. Activity of 5,6,7,8-tetrahydroimidazo[1,2- a ]pyrazine hybrids against Sporothrix depended on the substitution on the imidazopyrazine ring. Conclusion: Antifungal potential, overcoming itraconazole resistance and low toxicity indicate the possible use of that series of compounds in a therapeutic alternative for treatment of sporotrichosis.

We investigated the level of hearing tolerance in patients with first-episode psychosis (FEP) and panic disorder (PD) as compared to two different groups of healthy controls (HC, HC2), one for each experiment, because we used two distinct psychophysical paradigms. We evaluated auditory discomfort of 28 volunteers (14 with FEP and 14 HC) in the first study and of 42 volunteers (21 with PD and 21 HC2) in the second study. We presented 20 sounds: 16 pure-tone frequency sweeps (specially designed for use with FEP) and 11 s or 13 s musical sequences from the very beginning of the music "Play the Game" (PLAY) from Queen and its reverses. The first procedure used a Likert-like 0-10 scale ranging from "nothing bad" to "too bad" where volunteers made vertical marks along a horizontal line according to their discomfort. The second procedure involved subjective magnitude estimation online due to the SARS-COV-19 pandemic. Sounds were placed online and played by PD and HC2 volunteers themselves after having listened to the standard (the first 8 s from RADIO, "Radio Ga Ga" by Queen). Then, PD and HC2 volunteers were asked to assign values equal to, or multiples of 10 that felt like, or proportional to, their hearing "discomfort" in comparison with Sound 00 (RADIO). Our findings showed that FEP volunteers assign more discomfort to the 16 specially designed frequency sweep stimuli that appear not to affect HC, HC2, and PD. On the other hand, musical sequences from PLAY caused strong discomfort to PD in the reverse mode, but did not seem to affect HC, HC2, and FEP. Further experiments using the exact same paradigm with FEP and PD are needed to explore these findings., (© 2022. The Author(s).)

Awareness of perceptual and sensory changes that might occur in visual, auditory, proprioception, and other senses, in the early stages towards the First Episode Psychosis (FEP), and their subsequent sensorial evolution as the disturb progresses deeper into an acute episode, might be a key element for interrupting the process. In the present study, we investigated hearing discomfort/tolerance to 16 given sound streams. Sixteen people diagnosed with FEP, participated in the experiment. Sixteen frequency sweeps varying in modulation envelopes (sawtooth, sine), order (ascending, descending), duration (4s, 8s), and range (50-8000 Hz, 2-8 kHz) were presented randomly, but always in the same sequence, to FEP and healthy controls (HC). The level of discomfort was estimated by the participant by making a mark across a continuous line whose extremes read "nothing bad" (left) and "too bad" (right). Results showed that ascending sine pure frequency sweeps (p < 0.01) and descending sine pure frequencies sweeps (p < 0.01) caused the maximum discomfort in FEP. Other variables also showed differences between FEP and HC, and FEP were always more intolerant to such pure frequency sweeps than HC. We conclude that this might be useful for very early assessment of people at risk, people with FEP, and people with schizophrenia., (© 2022. The Author(s).)

Background: Human behavior is crucial in health outcomes. Particularly, individual behavior is a determinant of the success of measures to overcome critical conditions, such as a pandemic. In addition to intrinsic public health challenges associated with COVID-19, in many countries, some individuals decided not to get vaccinated, streets were crowded, parties were happening, and businesses struggling to survive were partially open, despite lockdown or stay-at-home instructions. These behaviors contrast with the instructions for potential benefits associated with social distancing, use of masks, and vaccination to manage collective and individual risks., Objective: Considering that human behavior is a result of individuals' social and economic conditions, we investigated the social and working characteristics associated with reports of appropriate protective behavior in Brazil., Methods: We analyzed data from a large web survey of individuals reporting their behavior during the pandemic. We selected 3 common self-care measures: use of protective masks, distancing by at least 1 m when out of the house, and handwashing or use of alcohol, combined with assessment of the social context of respondents. We measured the frequency of the use of these self-protective measures. Using a frequent pattern-mining perspective, we generated association rules from a set of answers to questions that co-occur with at least a given frequency, identifying the pattern of characteristics of the groups divided according to protective behavior reports., Results: The rationale was to identify a pool of working and social characteristics that might have better adhesion to behaviors and self-care measures, showing these are more socially determined than previously thought. We identified common patterns of socioeconomic and working determinants of compliance with protective self-care measures. Data mining showed that social determinants might be important to shape behavior in different stages of the pandemic., Conclusions: Identification of context determinants might be helpful to identify unexpected facilitators and constraints to fully follow public policies. The context of diseases contributes to psychological and physical health outcomes, and context understanding might change the approach to a disease. Hidden social determinants might change protective behavior, and social determinants of protective behavior related to COVID-19 are related to work and economic conditions., Trial Registration: Not applicable., (©Gabriel Urbanin, Wagner Meira, Alexandre Serpa, Danielle de Souza Costa, Leonardo Baldaçara, Ana Paula da Silva, Rafaela Guatimosim, Anísio Mendes Lacerda, Eduardo Araújo Oliveira, Andre Braule, Marco Aurélio Romano-Silva, Antônio Geraldo da Silva, Leandro Malloy-Diniz, Gisele Pappa, Débora Marques Miranda. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 15.06.2022.)

This paper deals with the problem of modeling counterfactual reasoning in scenarios where, apart from the observed endogenous variables, we have a latent variable that affects the outcomes and, consequently, the results of counterfactuals queries. This is a common setup in healthcare problems, including mental health. We propose a new framework where the aforementioned problem is modeled as a multivariate regression and the counterfactual model accounts for both observed and a latent variable, where the latter represents what we call the patient individuality factor ( φ ). In mental health, focusing on individuals is paramount, as past experiences can change how people see or deal with situations, but individuality cannot be directly measured. To the best of our knowledge, this is the first counterfactual approach that considers both observational and latent variables to provide deterministic answers to counterfactual queries, such as: what if I change the social support of a patient, to what extent can I change his/her anxiety? The framework combines concepts from deep representation learning and causal inference to infer the value of φ and capture both non-linear and multiplicative effects of causal variables. Experiments are performed with both synthetic and real-world datasets, where we predict how changes in people's actions may lead to different outcomes in terms of symptoms of mental illness and quality of life. Results show the model learns the individually factor with errors lower than 0.05 and answers counterfactual queries that are supported by the medical literature. The model has the potential to recommend small changes in people's lives that may completely change their relationship with mental illness., (© The Author(s), under exclusive licence to Springer Science+Business Media LLC, part of Springer Nature 2022.)

In this study, we compared visual pictorial size perception between healthy volunteers (CG) and an experimental group (EG) of people diagnosed with schizophrenia. We have been using paintings by Salvador Dalí and Rorschach plates to estimate visual pictorial size perception. In this transversal, ex post facto, and quasi-experimental study, we observed differences between EG and CG. Schizophrenic in-patients perceived sizes about 1.3-fold greater than healthy volunteers (p=0.006), implying that pictorial size perception is altered in some way in schizophrenia. Considering the present and previous results, this measurement of diameter size of first pictorial perception may be a useful estimate of some aspects of perceptual alterations that may be associated with psychotic symptoms in prodromal and acute schizophrenic episodes and other related mental states. Eventually, this may help in preventing people from evolving to acute episodes., (© 2021. The Author(s).)

Purpose: To investigate the existence of faster vs slower recovery profiles in futsal and factors distinguishing them., Methods: 22 male futsal players were evaluated in countermovement jump, 10-m sprint, creatine kinase, total quality of recovery (TQR), and Brunel Mood Scale (fatigue and vigor) before and immediately and 3, 24, and 48 h posttraining. Hierarchical cluster analysis allocated players to different recovery profiles using the area under the curve (AUC) of the percentage differences from baseline. One-way ANOVA compared the time course of each variable and players' characteristics between clusters., Results: Three clusters were identified and labeled faster recovery (FR), slower physiological recovery (SLphy), and slower perceptual recovery (SLperc). FR presented better AUC in 10-m sprint than SLphy (P = .001) and SLperc (P = .008), as well as better TQR SLphy (P = .018) and SLperc (P = .026). SLperc showed better AUC in countermovement jump than SLphy (P = .014) but presented worse fatigue AUC than SLphy (P = .014) and FR (P = .008). AUC of creatine kinase was worse in SLphy than in FR (P = .001) and SLperc (P < .001). The SLphy players were younger than SLperc players (P = .027), whereas FR were slower 10-m sprinters than SLphy players (P = .003) and SLperc (P = .013) and tended to have higher maximal oxygen consumption than SLphy (effect size =1.13)., Conclusion: Different posttraining recovery profiles exist in futsal players, possibly influenced by their physical abilities and age/experience.

It has been suggested that technetium-99m (99mTc)-anti-tumour necrosis factor alpha (TNF-α) scintigraphy (SCI) may be a useful diagnostic tool in Graves' ophthalmopathy (GO). This study evaluated whether orbit total radioactivity uptake on SCI could be used to predict corticosteroid therapy (CorT) responses in active-GO patients. A longitudinal study of patients with active GO defined by Clinical Active Score (CAS) >3/7 was done. Clinical, laboratory and SCI evaluations were performed at baseline and 3 months after concluding intravenous CorT. SCI (planar and tomographic) was assessed after intravenous injection of 10 mCi of 99mTc-anti-TNF-α. Orbits and cerebral hemispheres were defined as regions of interest (ROIs) to enable orbit/hemisphere ROI-ratios of total radioactive uptake. ROI-ratios were considered positive at >2·5. Average total radiation uptake (TRU) was also determined for each orbit (AVG ROI ). Clinical, laboratory and SCI data were compared between responders (CAS became inactive) and non-responders to CorT (18 patients). At baseline, AVG ROI were higher in active OG orbits (67·3 cps) than in inactive ones (33·6 cps; P<0·05). AVG ROI (absolute values) reduced (-29·9 cps) in CorT responders and tended (P = 0·067) to differ from variations occurred in non-responders (+6·9 cps in patients with maintained CAS positivity post-treatment). Higher baseline ROI-ratios (4·9 versus 3·3; P = 0·056) and its pronounced reductions following CorT (-37% versus +56% in non-responders; P = 0·036) tended to be associated with good CorT responses in the subgroup of GO history ≥1 year. SCI showed a good association with active eye disease and may be an additional tool to identify CorT responders., (© 2018 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)

Background: Cryptococcus gattii-induced cryptococcosis is an emerging infectious disease of humans and animals with worldwide distribution and public health importance due to its significant morbidity and mortality rate. The present study aimed to report a case of pulmonary infection by C. gattii molecular type VGII in State of São Paulo, Brazil., Case Presentation: A 5-year-old goat showing intermittent dry cough, ruminal tympany, anorexia, fever, tachycardia and tachypnea was presented for necropsy at the Veterinary Hospital of the School of Veterinary Medicine and Animal Sciences, São Paulo University, São Paulo, Brazil. Postmortem examination revealed numerous 2.0-6.0 cm diameter yellow gelatinous pulmonary masses. Tissues were evaluated by a combination of pathological, mycological, and molecular diagnostic techniques. Microscopically, pneumonia granulomatous, multifocal to coalescing, moderate, with many intralesional carminophilic yeasts was observed. The immunohistochemistry and mycological culture confirmed Cryptococcus spp. Internal transcribed spacers and orotidine monophosphate pyrophosphorylase nucleotide differentiation demonstrated that the isolate corresponds to the C. gattii VGII molecular subtype., Conclusions: To our knowledge, this is the first report of a pulmonary infection in a goat linked to C. gattii molecular type VGII in Southeastern Brazil. Our findings emphasize the need for an active surveillance program for human and animal new infections to improve the current public health policies due to expansion of the epidemiological niche of this important microorganism.

A photocatalyst consisting of nanostructured Pd photochemically deposited on 20 nm TiO2 displays a reaction half-life for rhodamine b decolourisation of 0.5 minute compared to the 9.4 minutes for unmodified P25 under identical reaction conditions. We associate this increased decolourisation rate to the increase in solar light harvesting which we have measured at 8% due to a significant red shift in the absorption profile of the catalyst. We relate the increased absorption of light with a visible active plasmon effect that is associated with the Pd nanostructures on the TiO2. This overall red-shift in the light harvesting for the catalyst leads to photocatalytic activity for excitations up to 600 nm.

Case Report: A 10-year-old male was referred to our institution due to short stature and bilateral cryptorchidism and reported pubic hair development and acne since the age of 4 years. Laboratory and molecular genetic tests indicated congenital adrenal hyperplasia due to 21-hydroxylase deficiency. After treatment with prednisone, adrenal hormones normalised but testosterone remained elevated. Magnetic resonance imaging of the abdomen due to cryptorchidism revealed uterus and adnexal attachments, a prostate and poorly defined nodules on the iliac chains. Upon exploratory laparotomy, a hysterectomy, bilateral oophorectomy and resection of a peri-adnexal nodular lesion on the patient's right side were performed. Histopathology of the nodule mass was compatible with a Leydig cell tumour with a low proliferation rate according to Ki67., (Copyright © 2013 S. Karger AG, Basel.)

Adrenal incidentalomas (AI) are unsuspected adrenal masses discovered during investigation of unrelated diseases, and are increasing in frequency. The majority of the AI is non-secretory adenomas, although it can also represent primary or metastatic malignant neoplasia. However, less frequent diseases should not be forgotten in the differential diagnosis. We describe a case of a young woman with an adrenal mass without clinical or laboratorial signs of hormonal hyperfunction. Diagnosis was performed after an episode of acute pyelonephritis in which the imaging study was carried out in order to exclude local complications. During the surgical procedure, the fish flesh aspect of the mass raised the suspicion of a neurogenic tumor, which was diagnosed in the histophatological analysis. The patient presented the most common manifestation of adrenal ganglioneuroma, an incidentaloma.

This work was based on the analysis of digital images of histochemical profile from subcutaneous lesions in sporotrichosis (ST) and chromoblastomycosis (CM) patients. An additional aim was the detection of carbohydrate expression using lectin histochemical analysis of the different carbohydrates in the fungal cell wall from four different species (Sporothrix schenckii, Fonsecaea pedrosoi, Phialophora verrucosa, and Cladophialophora carrionii) associated with diseases mentioned earlier. Slides from tissue biopsies from ST and CM positive patients (n=10, each) were stained according to routine techniques. Slides were incubated with 25 μg/ml of Con A lectins and WGA conjugated to peroxidase. Digital image analysis was carried out in a workstation using OPTIMAS™ software system. Routine histochemistry results indicated that there is significantly higher collagen deposition and elastic fibers in ST characteristic lesions compared with that found in CM cases. The ST interstitial fibrosis area was larger than in CM lesions. Comparative lectin binding showed a positive and intense lectin staining pattern in the cell wall of S. schenckii, suggesting a higher expression of glucose/mannose and N-acetyl glucosamine in their cell surface as evidenced by Con A and WGA, respectively. However, these lectins were not effective to recognize some carbohydrates moieties in the F. pedrosoi, P. verrucosa, and C. carrionii. Such findings contribute to additional information about specific recognition processes between fungal parasites and their host cell targets may be mediated by the interaction of carbohydrate-binding proteins, such as lectins, on the surface of one type of cell that combine with complementary sugars on the surface of another cells into fibro-connective tissues associated with lesions., (© Springer Science+Business Media B.V. 2011)

Background: Chagas disease is endemic in South and Central America, where 18 million individuals are infected by Trypanosoma cruzi, causing congestive heart failure (CHF) and cardioembolic stroke. Transcranial Doppler (TCD) is able to detect real-time microembolic signals (MES) to the brain vessels and may represent a surrogate marker of stroke risk. We aimed to determine predictors of MES in a population of patients with CHF., Methods: Consecutive CHF patients from a university-based cardiomyopathy clinic underwent TCD recording of the middle cerebral artery for 60 min by a single investigator who was blinded to all clinical data including cardiomyopathy etiology. Predictors of MES were sought by multivariable logistic regression analysis., Results: From April 2004 to February 2009, 144 patients were studied, including 62 (44.6%) patients with Chagas disease. MES were detected in 9 (6.2%) patients and were more frequent in patients with Chagas disease than in patients with other causes of CHF (12.9 vs. 1.2%, p = 0.005). In multivariate analysis corrected for age and left-ventricular ejection fraction, predictors of MES were Chagas disease (odds ratio = 1.15, 95% confidence interval = 1.05-1.26, p = 0.004) and stroke history (odds ratio = 1.27, 95% confidence interval = 1.08-1.50, p = 0.005)., Conclusions: Chagas disease and stroke history are risk factors for MES independent of cardiac disease severity. Other mechanisms besides structural cardiac disease may be operative, increasing embolic risk in Chagas disease., (Copyright © 2010 S. Karger AG, Basel.)

We recently demonstrated that automatic attention favors the right side of space and, in the present study, we investigated whether voluntary attention also favors this side. Six reaction time experiments were conducted. In each experiment, 12 new 18-25-year-old male right-handed individuals were tested. In Experiments 1, 2, 3 (a, b) and 4 (a, b), tasks with increasing attentional demands were used. In Experiments 1, 2, 3a, and 4a, attention was oriented to one or both sides by means of a central spatially informative visual cue. A left or right side visual target appeared 100, 300, or 500 ms later. Attentional effects were observed in the four experiments. In Experiments 2, 3a and 4a, these effects were greater when the cue indicated the right side than when it indicated the left side (respectively: 16 +/- 10 and 44 +/- 6 ms, P = 0.015, for stimulus onset asynchrony of 500 ms in Experiment 2; 38 +/- 10 and 70 +/- 7 ms, P = 0.011, for Experiment 3a, and 23 +/- 11 and 61 +/- 10 ms, P = 0.009, for Experiment 4a). In Experiments 3b and 4b, the central cue pointed to both sides and was said to be non-relevant for task performance. In these experiments right and left reaction times did not differ. The most conservative interpretation of the present findings is that voluntary attention orienting favors the right side of space, particularly when a difficult task has to be performed.

Chagas disease (CD) remains a major cause of stroke in developing countries, but cognitive repercussion of CD has not been well studied., Objective: To compare the frequency and pattern of cognitive dysfunction in patients with CD cardiomyopathy (CDC) and other cardiomyopathies (OC)., Methods: We studied 37 patients with CDC and 42 patients with OC with similar age, educational level and cardiac systolic function. Cognitive tests were applied to both groups by a single examiner blinded to CD status. Logistic regression multivariable models were constructed to ascertain predictors of cognitive dysfunction for each test., Results: Cognitive dysfunction was detected in 9 (24%) CDC patients and 6 (14%) OC patients by Mini Mental State Exam (MMSE) corrected for educational level. Independent predictors of abnormal MMSE (p<0.05) included stroke history (OR=5.51; 95% CI=1.27-24.01) and digoxin use (OR=0.23, 95% CI=0.06-0.89), while CD showed a trend toward statistical significance (OR=4.63; 95% CI=0.87-24.73, p= 0.07). Delayed recall of Rey's Complex Figure Test was significantly worse in CD patients, where this remained a significant predictor in the multivariable analysis (OR=4.67; 95% CI=1.23-17.68)., Conclusions: Cognitive dysfunction is frequent in Chagas disease and should be considered as an outcome measure in Chagas disease studies., Competing Interests: Disclosure: The authors reports no conflicts of interest.

Background: Cissus sicyoides (Vitaceae) is a medicinal plant popularly known in Brazil as "cipó-pucá, anil-trepador, cortina, and insulina". The plant is used in several diseases, including rheumatism, epilepsy, stroke and also in the treatment of diabetes. In the present work, we studied the hypoglycemic and anti-lipemic effects of the aqueous extract prepared from fresh leaves of the plant (AECS), in the model of alloxan-induced diabetes in rats. In addition, hepatic enzyme levels were also determined., Results: Results showed that the daily treatment of diabetic rats with AECS for 7 days (100 and 200 mg/kg, p.o.) significantly decreased blood glucose levels in 25 and 22% respectively, as compared to the same groups before AECS treatment. No significant changes were seen in control diabetic rats before (48 h after alloxan administration) and after distilled water treatment. While no changes were seen in total cholesterol levels, a significant decrease was observed in plasma triglyceride levels, in the alloxan-induced diabetic rats after AECS treatment with both doses, as compared to the same groups before treatment. Significant decreases in blood glucose (25%) and triglyceride levels (48%) were also observed in the alloxan-induced diabetic rats after 4 days treatment with AECS (200 mg/kg, p.o.). Aspartate (AST) and alanine (ALT) aminotransferases levels, in diabetic controls and AECS-treated rats, were in the range of reference values presented by normal rats., Conclusions: The results justify the popular use of C. sicyoides, pointing out to the potential benefit of the plant aqueous extract (AECS) in alternative medicine, in the treatment of type 2 diabetes mellitus.

A case of a skull fibrosarcoma compressing the right lateral sinus is presented as a rare cause of intracranial hypertension.