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Abstract Background Resilience is a crucial factor in students’ mental health, playing an important role in their successful adaptation to the academic environment. However, there is a lack of understanding about resilience and its associated factors in students from different undergraduate courses. This study aimed to describe the resilience profile of undergraduate students from various courses in Brazil and identify sociodemographic, economic, and academic factors associated with resilience. Methods This study has data from a cross-sectional multicenter study involving undergraduate students from eight Federal Institutions of Higher Education in Minas Gerais, Brazil. The dependent variable was resilience, measured using the Connor-Davidson Resilience Scale (CD-RISC) 10-item version, with sociodemographic, economic, and academic factors considered independent variables. Data was collected virtually via a self-administered questionnaire between October 2021 and February 2022 (during the covid-19 pandemic). Independent samples t-tests and ANOVAs were conducted to compare resilience scores between independent variables, and Tukey’s post-hoc test was performed when necessary. Multiple linear regression was performed to create three models. Results 8,650 undergraduate students were included in this study. The average score on the resilience scale was 19.86 ± 8.15, with a normal distribution. The respondents ranged from 18 to 71 years old, averaging 23.9 ± 6.33. Being female, not having a religious belief, having low per capita family income, having had a decrease in the family income, not being heterosexual, or having the head of the family with a low education level were the main factors associated, individually, with low resilience scores in the sociodemographic and economic multiple linear regression model constructed. Being from linguistics, letters and arts courses, being enrolled in fewer subjects, or being from UFMG were the main factors associated, individually, with low resilience scores in the academic multiple linear regression model constructed. Conclusions The study’s findings revealed that sociodemographic, economic, and academic variables were significantly associated with resilience scores in undergraduates from Minas Gerais during the covid-19 pandemic. These findings can help universities develop target strategies to promote students’ resilience and reduce the risk of poor mental health among this population.

Abstract Objective To evaluate the effects of replacing time spent in sedentary behavior (SB) with moderate to vigorous physical activity on sleep quality in young adults. Methods Multicenter cross-sectional study, carried out with students enrolled in undergraduate courses at universities in Brazil. Sleep quality was assessed using a question of the World Health Organization Quality of Life (WHOQOL-brief) and classified as good or poor sleep quality. SB was evaluated by self-reported total sitting time, and the level of leisure-time PA was classified according to the intensity of moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA), which were assessed using a self-reported questionnaire. An isotemporal replacement logistic model was used to evaluate the effects of different SB, MPA, and VPA sessions on sleep quality. Results A total of 8,059 study participants were evaluated, the majority had poor sleep quality (64.79%), were physically inactive (48.28%, defined as practicing

Many studies have shown that translanguaging promotes inclusive and dynamic learning environments. However, little is known about multimodal techniques to improve student engagement and satisfaction. The present study aims to examine the impact of these combined strategies on student understanding, motivation, and identity construction in language acquisition. The study involved twenty students in the second semester of the English Language Education Department at a university in Bekasi, West Java, Indonesia. The data were garnered through a quantitative method using a questionnaire and a qualitative method using in-depth interviews. Out of the total number of participants, five students were selected for in-depth interviews to explore rich data on students' emotional, motivational, cognitive, and expressive responses to translanguaging. The data obtained from the questionnaire were analyzed statistically while the data obtained from the interviews were analyzed using thematic analysis. The results suggest that adding translanguaging and multimodal strategies to the learning environment promotes a more engaging and inclusive atmosphere, thereby enhancing student satisfaction and language proficiency. Conversely, complications were identified for students with diminished proficiency requiring further assistance. The research emphasizes the potential of translanguaging to enhance linguistic competence, student confidence, and motivation, indicating that it is a valuable pedagogical tool in EFL classrooms.

Objetivo: Descrever as características das internações hospitalares por queda entre os idosos na cidade de São Paulo. Métodos: Trata-se de um estudo transversal, retrospectivo. Foram estudados dados secundários do Sistema Único de Saúde (SUS) sobre idosos com 60 anos ou mais de idade que tiveram internação hospitalar por queda acidental durante o ano de 2013 na cidade de São Paulo. Resultados: Foram registradas 8.234 internações hospitalares por queda acidental de idosos em 2013. As fraturas mais recorrentes devido à queda acidental foram: fratura de fêmur (32,9%) e traumatismo intracraniano (15,8%). Conclusão: No presente estudo foi encontrada uma frequência maior de internações por queda acidental no sexo feminino, e as internações por queda acidental foram maiores no grupo de idosos com 80 anos ou mais. O principal diagnóstico de internação foi a fratura do fêmur; como consequência, foram empregados o tratamento cirúrgico de fratura transtrocanteriana e as artroplastias.

Probióticos, prebióticos e simbióticos são chamados de alimentos funcionais (AF). A utilização deles estimula a proliferação de bactérias benéficas, em detrimento da proliferação de bactérias prejudiciais, reforçando os mecanismos naturais de defesa do hospedeiro, mantendo o equilíbrio, podendo estimular diretamente a imunidade, a proteção contra patógenos e evitar a infecção por Clostridium decorrente do uso de antibioticoterapia. É comum que os pacientes evoluam com distúrbios do trato gastrointestinal (TGI) capazes de aumentar o tempo de internação, ocasionando outras complicações, como infecções respiratórias e úlceras por pressão. O objetivo do estudo foi identificar aspectos referentes ao uso de simbióticos, prebióticos e probióticos em adultos e/ou idosos e descrever as vantagens e desvantagens de sua utilização. Foi realizada uma revisão bibliográfica por enfermeiros de unidade semi-intensiva de um hospital de grande porte da cidade de São Paulo entre os anos de 2011 e 2012. Utilizou-se como eixo norteador o questionamento: é possível beneficiar os pacientes internados com o uso de prebióticos, probióticos e simbióticos, prevenindo assim as complicações do trato gastrointestinal? Concluiu-se que diversas complicações dos pacientes internados decorrentes de alterações do TGI, como inapetência, distúrbios hidroeletrolíticos, desidratação, suscetibilidade para a formação de úlceras por pressão, dermatites etc. podem ser evitadas com o uso contínuo desses produtos. Essa intervenção reduziria o tempo de internação, o custo hospitalar e o tempo despendido pela equipe de enfermagem em situações preveníveis. Não ficaram claras as desvantagens quanto ao uso desses produtos.

Objetivo: Verificar os efeitos de um programa de treinamento resistido ondulatório supervisionado, sobre variáveis antropométricas e da aptidão funcional em idosos com diabetes do tipo 2. Material e métodos: Participaram do estudo 51 idosos de ambos os gêneros, na faixa etária de 60 a 85 anos, com diagnóstico de diabetes do tipo 2. Foram avaliados o índice de massa corporal (IMC), a medida do perímetro da cintura (PC) e o perímetro do quadril (PQ) conforme orientação prévia. Além disso, com as medidas do PC e PQ, pôde ser calculada a relação cintura-quadril (RCQ). A aptidão funcional foi avaliada por meio de uma bateria de testes direcionados à avaliação motora de idosos, que foi composta por cinco testes singulares: sentar e alcançar no banco de Wells; resistência de força de membros superiores; agilidade e equilíbrio dinâmico; sentar e levantar; equilíbrio unipodal; ergoespirometria em esteira ergométrica. Resultados: O treinamento físico não induziu alterações nos parâmetros antropométricos, mas melhorou o desempenho no teste de sentar e levantar, agilidade e equilíbrio dinâmico. Para as demais capacidades físicas testadas (flexibilidade, equilíbrio e capacidade aeróbia), as 16 semanas de período de intervenção não se mostraram capazes de induzir mudanças significativas nos idosos com diabetes. Conclusão: O treinamento resistido ondulatório teve efeito positivo sobre a aptidão funcional de idosos com diabetes do tipo 2, com efeitos mais pronunciados nos membros inferiores.

Objetivos: Avaliar aspectos cognitivos e motores em idosos com doença de Parkinson (DP) antes e após treinamento por meio de 6 jogos de videogame. Métodos: Estudo com 9 sujeitos, de ambos os sexos. Passaram por anamnese clínica detalhada e foram submetidos a 7 sessões de treinamento por meio dos jogos: Cabeceio, Ski Slalom, Table Tilt Plus, Snowball Fight, Balance Bubble Plus e Big Top Juggling. Foi utilizada a análise estatística de Wilcoxon a fim de comparar o desempenho dos participantes na primeira e sétima sessões. Resultados: Os resultados mostraram melhora de funções motoras e cognitivas. Os jogos do Cabeceio (Z = -2,207; p = 0,027), Snowball Fight (Z = -2692; p = 0,007), Table Tilt Plus (Z = -2,428; p = 0,015), Balance Bubble Plus (Z = -2,547; p = 0,011) e Big Top Juggling (Z = -2,549; p = 0,011) mostraram diferenças estatisticamente significativas entre as sessões. Conclusão: Pode-se concluir que o treinamento com jogos virtuais mostrou-se importante na melhora motora e cognitiva dos pacientes desta pesquisa. Sugere-se o treinamento com jogos virtuais que envolvam dupla tarefa, mais uma possibilidade de tratamento.

Objetivo. Sistematizar evidências sobre o efeito de intervenções mundiais para a redução do consumo e/ou venda de bebidas alcoólicas. Método. Mapa de evidências que, a partir de buscas em nove bases bibliográficas, incluiu 182 estudos de revisões sistemáticas com ou sem metanálises, revisões de intervenções e revisões de revisões. Os estudos avaliaram o efeito de intervenções - agrupadas em conjuntos abrangentes de ações: comunicação para mudança de comportamento; ambientes promotores da saúde e mudanças dos sistemas - sobre dois desfechos de interesse: redução de consumo e redução da compra e/ou venda de álcool. Resultados. Foram registradas 207 associações entre diferentes intervenções e desfechos, com destaque para intervenções de comunicação para mudança de comportamento (81,64%) e para o desfecho de redução de consumo (98,55%). A maioria das associações apresentou efeito positivo (40,58%), inconclusivo (28,99%) ou potencialmente positivo (26,57%). Das intervenções com resultado positivo ou potencialmente positivo, destacam-se o monopólio de vendas de bebidas alcoólicas pelo governo, controle de densidade de pontos de venda, cobrança de preço mínimo por unidade, advertências sanitárias em rótulo de bebidas alcoólicas e múltiplas intervenções integradas. Conclusão. Espera-se que o presente mapa auxilie formuladores de políticas públicas e profissionais de saúde na adaptação de experiências para seus contextos de atuação, estimulando ações intersetoriais para reduzir o consumo de álcool.

Defined as the benefits derived from nature to humans, the Ecosystem Services (ES) concept clarifies how ecosystems contribute to human well-being. Despite its relevance, integrating this concept into decision-making processes remains a challenge. Participatory approaches have proven crucial in developing mechanisms for managing, conserving, sustainably using and valuing ES. This work aimed to analyse the perceptions of Portuguese Biosphere Reserves’ (BR) managers regarding the ES provided by these territories through a participatory workshop. During the workshop, each participant specified the most relevant ES provided by the BR. The study identified three key ES: "Cultivated terrestrial plants (including fungi, algae) grown for nutritional purposes", "Characteristics of living systems that enable scientific investigation or the creation of traditional ecological knowledge" and "Characteristics of living systems that enable education and training". Additionally, participants discussed perceived threats, opportunities and potential solutions to enhance the value of these key ES in these areas. "Climate change" and "Pollution" were identified as the most significant threats, while "Climate adaptation", "Quality of life" and "Sustainable agriculture" emerged as the main opportunities. Solutions to address threats and maximise opportunities include the establishment of a closer, systematic and articulated relationship within BR to promote sustainability and resilience. Overall, the workshop was positively evaluated and deemed productive. It was also considered a powerful tool to foster collaboration towards a more holistic promotion of BR' sustainable governance, benefitting the environment, communities and the economy.

Abstract Background To investigate predictors of navigated subthreshold micropulse laser (SML) treatment in chronic central serous chorioretinopathy (cCSC). Methods In this single-center prospective consecutive case series, patients with cCSC were treated with 577 nm SML and followed up for 12 months. A complete ophthalmological evaluation including spectral optical coherence tomography (SD-OCT), fluorescein angiography (FA) and microperimetry (MP) was performed. FA hyperfluorescence patterns and SD-OCT features were investigated. Results Overall, 38 eyes from 38 patients affected by cCSC with a mean age of 48.20 ± 5.95 years were included. Thirty-one eyes (81.6%) demonstrated a significant subretinal fluid (SRF) reduction after treatment at 3 months. Complete SRF resolution was achieved by twenty-three patients (60.5%) at 3 months and attained by an additional patient (24 in total, 63.2%) at 6 months. Twenty-two (57.9%) of such individuals were confirmed with no SRF at the end of the follow-up. Best-corrected visual acuity improved significantly and progressively at all timepoints from baseline, in parallel with macular sensitivity (all p:

INTRODUCTION: Manual tracing is an effective method to measure hippocampal volume. OsiriX™ is a Digital Imaging and Communications in Medicine (DICOM) viewer with an intuitive user interface that has been widely used by radiologists and other specialists in their daily practice. OBJECTIVE: To describe OsiriX™, a tool for in office manual measurement of hippocampal volume. METHODS: The open-source OsiriX™ viewer was used with three dimensions (3D) T1 weighted spoiled gradient recalled echo (SPGR) sequence images, with 1 mm slice thickness and 0.1mm gap (voxel size 1 mm3). Magnetic Resonance Imagings (MRI) were obtained on a 1.5 T system. The entire procedure lasted less than 15 minutes for each hippocampus. CONCLUSION: OsiriX™ viewer is a feasible tool for in office manual hippocampal measurement. There is no standard hippocampal volume for Alzheimer’s disease, thus comparison could be regarded as the rate of hippocampal atrophy over time, correlated with clinical evaluation and cognitive tests.

We report the first detection of Trissolcus japonicus in southwestern France. A total of almost 3000 sentinel and 700 field-laid egg masses of Halyomorpha halys were exposed or collected in the administrative region of Nouvelle-Aquitaine in 2022 and 2023. A total of 12 and 44 specimens of T. japonicus emerged from one and two egg masses in 2022 and 2023, respectively. Morphologic analysis confirmed the identification of this egg parasitoid, while molecular analysis of COI matched the haplotype of the French population to the population of T. japonicus released in Italy. Trissolcus japonicus may have arrived in Nouvelle-Aquitaine from introduction pathways similary to T. mitsukurii, detected in 2020, although these pathways cannot be clearly defined. The co-occurrence of these two major parasitoids of BMSB should now be surveyed as possible competition can arise. In the frame of the biological control program currently running in France against BMSB, the use of one or two parasitoid species is also considered.

Abstract Colorectal cancer (CRC) is a leading cause of morbidity and mortality worldwide. Detection before metastasis and efficient treatment of disease significantly improve patient survival and quality of life. However, limitations in diagnosis and postoperative surveillance are associated with low CRC detection and survival rates. Thus, this project aimed to evaluate the molecular profile of patients diagnosed with CRC, as molecular biomarkers constitute a new frontier for diagnosis, treatment and prognosis. Methods and Results: 42 patients were included in the study, predominantly male (59.5%), with a median age of 63 years (SD: 10.0; min: 41; max: 83). The majority of primary tumors were located in the rectum (38.1%), in the sigmoid (33.3%) and in the ascending (21.4%) colon. We evaluated the genes KRAS, NRAS, BRAF, EGFR and TP53 using Sanger sequencing. Somatic and germline mutations were found in the KRAS, EGFR and TP53 genes, with the most common somatic alteration being rs121913529 in KRAS. This variant was also strongly associated with alcoholism (p = 0.002). Furthermore, patients with somatic mutations in TP53 had significantly higher mortality compared to those with wild-type alleles (OR: 11.2; 95% CI 1.25–2.45). Conclusions: Our findings support a relationship between alcohol consumption and the rs121913529 mutation, which is classified as pathogenic for colorectal cancer. Thus, further studies investigating the link between alcohol consumption, colorectal carcinogenesis and tumor progression ought to be conducted.

Abstract RNA interference (RNAi) is double stranded RNA (dsRNA)-based gene silencing mechanism. Exogenous dsRNAs application to crops has raised as a powerful tool to control agricultural pests. In particular, several sap-feeder are important plant pathogens vectors, such as Philaenus spumarius, known as main vector of Xylella fastidiosa (Xf), causal agent of olive quick decline syndrome (OQDS) in southern Italy. Here, dsATP synthase beta (dsATP), dsLaccase (dsLacc) and dsGreen Fluorescent Protein (dsGFP) as control, were provided to spittlebug adults by microinjection or to nymphs fed on dsRNA-treated plant shoots. Treated insects were collected at different time points to monitor silencing efficiency over time, describing significant reduction of transcript levels from 8 to 24 days post treatment. Downregulation of target genes ranged from 2- to 16-fold compared to the corresponding dsGFP controls, where highest silencing effects were generally noticed for ATP synthase beta. Sequencing of libraries obtained from total smallRNA (sRNA) showed the generation of dsRNA-derived sRNAs by RNAi pathway, with majority of reads mapping exclusively on the correspondent dsRNA. Also, we characterized components of a functional RNAi machinery in P. spumarius. Further research is needed to clarify such mechanism, screen effective target lethal genes to reduce vector population and improve delivery strategies.

OBJECTIVE: To conduct an integrative literature review on epidemiology of falls in older adults in Brazil, seeking to identify occurrence rate, recurrence, and potentially modifiable factors associated with these events. METHOD: This literature review consisted of searching the Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO), and Latin American and Caribbean Center on Health Sciences Information (LILACS) databases for scientific articles on November 14, 2017. The following keywords were used for finding articles: “accidental falls,” AND/OR “elderly,” AND/OR “Brazil.” Epidemiological data were collected from primary studies and then compared. RESULTS: Thirty-five studies were selected. Most of them were performed in the Brazilian Southeast (15) and South (11) regions. The occurrence rate of falls ranged from 10.7 to 59.3%. The most common setting for falls was the home during daytime. The most commonly described circumstances were tripping, slipping, dizziness, and uneven flooring, resulting in falling from one’s own height. The factors most frequently associated with falls were female sex, age greater than 80 years, cognitive impairment, and depressive symptoms. The reported consequences were fractures and fear of falling again. CONCLUSION: As some factors associated with falls in older adults in Brazil are modifiable, fall prevention may reduce morbidity and mortality in this population.

Abstract Excessive dietary fat intake increases plasma lipid levels and has been associated with reduced bone mineral density (BMD) and increased risk of osteoporotic fracture, especially in older postmenopausal women. The objective of this study was to investigate whether there are sex-related differences in lipid metabolism that could have an impact on large-scale bone regeneration. Because ribs provide a unique exception as the only bones capable of completely regenerating large-scale defects, we used a rib resection mouse model in which human features are recapitulated. After 10 days of exposure to a low-fat diet or high-fat diet (HFD), we performed large-scale rib resection surgeries on male and female mice (6–7 weeks old) with deletion of the low-density lipoprotein (LDL) receptor (Ldlr−/−) and age- and sex-matched wild-type (WT) mice were used as controls. Plasma analysis showed that short-term exposure to HFD significantly increases total cholesterol, LDL cholesterol, and triglycerides levels in Ldlr−/− mice but not in WT, with no differences between males and females. However, under HFD, callus bone volume was significantly reduced exclusively in male Ldlr−/− mice when compared to WT, although these differences were no longer apparent by 21 days after resection. Regardless of diet or genotype, BMD of regenerated ribs did not differ significantly between groups, although male mice typically had lower average BMD values. Together, these results suggest that short-term hyperlipidemia has transient effects on large-scale bone regeneration exclusively in male mice.

Abstract The RNA binding protein Human Antigen R (HuR) has been identified as a main regulator of the innate immune response and its inhibition can lead to beneficial anti-inflammatory effects. To this aim, we previously synthesized a novel class of small molecules named Tanshinone Mimics (TMs) able to interfere with HuR-RNA binding, and that dampen the LPS-induced immune response. Herein, we present a novel series of TMs, encompassing thiophene 3/TM9 and 4/TM10, furan 5/TM11 and 6/TM12, pyrrole 7b/TM13, and pyrazole 8. The furan-containing 5(TM11) showed the greatest inhibitory effect of the series on HuR-RNA complex formation, as suggested by RNA Electromobility Shift Assay and Time-Resolved FRET. Molecular Dynamics Calculation of HuR − 5/TM11 interaction, quantum mechanics approaches and Surface Plasmon Resonance data, all indicates that, within the novel heteroaryl substituents, the furan ring better recapitulates the chemical features of the RNA bound to HuR. Compound 5/TM11 also showed improved aqueous solubility compared to previously reported TMs. Real-time monitoring of cell growth and flow cytometry analyses showed that 5/TM11 preferentially reduced cell proliferation rather than apoptosis in murine macrophages at immunomodulatory doses. We observed its effects on the innate immune response triggered by lipopolysaccharide (LPS) in macrophages, showing that 5/TM11 significantly reduced the expression of proinflammatory cytokines as Cxcl10 and Il1b.

Abstract We propose a novel quantitative method to explore the forces affecting mitochondria within living cells in an almost non-invasive fashion. This new tool enables the detection of localized mechanical impulses on these organelles that occur amidst the stationary fluctuations caused by the thermal jittering in the cytoplasm. Recent experimental evidence shows that the action of mechanical forces has important effects on the dynamics, morphology and distribution of mitochondria in cells. In particular, their crosstalk with the cytoskeleton has been found to alter these organelles function; however, the mechanisms underlying this phenomenon are largely unknown. Our results highlight the different functions that cytoskeletal networks play in shaping mitochondrial dynamics. This work presents a novel technique to extend our knowledge of how the impact of mechanical cues can be quantified at the single organelle level. Moreover, this approach can be expanded to the study of other organelles or biopolymers.

Abstract Background Ovarian cryopreservation is a promising technique despite being hindered by damage from freezing and thawing. Melatonin can mitigate this outcome. Objective This study aimed to evaluate the effect of melatonin on the follicular dynamics of ovarian tissue in a cryopreserved cell culture. Methods Three-month-old adult female Wistar rats (n = 24) weighing approximately 250 g were oophorectomized and divided into two groups (n = 12): the control group (CG) and the melatonin group (MG). In the CG, slow cryopreservation was performed according to the standard protocol with Medium M2 and dimethyl sulfoxide (DMSO). In MG, melatonin diluted in ethyl alcohol vehicle at a concentration of 0.1 μm was added to the culture medium. In both groups, the ovaries were cryopreserved by slow freezing and kept in liquid nitrogen for 24 h. Subsequently, after thawing, the ovaries were reimplanted in the retroperitoneum, one on each side of the great vessels (inferior vena cava and aorta). After 30 days, the animals were euthanized during the diestrus phase; then, the grafts were removed and processed for histomorphometric and immunohistochemical analyses, whereas the blood was subjected to biochemical analysis. Student’s t test was used to assess the difference between the groups. Results The FSH levels in MG (83.79 ± 32.37) were lower than those in CG (120.52 ± 36.59), p = 0.03. The FSH/AMH ratios were also lower in MG (3.53 ± 1.13) than in CG (6.52 ± 2.85), p = 0.001. The SOD2 immunoexpression was higher in MG than in CG regarding all parameters except for the degenerated follicles (follicular cells and internal thecal cells): CG (16.80 ± 4.80 [13.36–20.24]) and MG (14.91 ± 4.04 [12.01–17.79]) p = 0.351. Statistically, the difference in intact follicles (theca + interstitium) between CG (6.60 ± 2.59 [4.75–8.45]) and MG (9.31 ± 3.09 [7.09–11.51]) was significant (p = 0.049), with a small difference in the expression of regular antral follicles. Conclusions Melatonin can improve the quality of cryopreserved tissues, as evidenced in this study, and the evaluation of cryopreserved ovarian grafts, as shown in the melatonin group with better hormonal parameters and greater immunohistochemical expression of the SOD2 antioxidant. Thus, damage is reduced during cryopreservation and transplantation is improved.

Abstract Predictive biomarkers of response to therapy are fundamental for the personalized therapeutic management of patients with colorectal carcinoma (CRC). The main predictive biomarkers related to CRC are the mismatch repair proteins/microsatellite instability status (MMR/MSI status), RAS/RAF mutation status and HER2 status. We discuss the scenarios in which these biomarkers are used and address different aspects that may affect the evaluation of each biomarker. We also address the increasingly recognized importance of circulating tumor DNA (ctDNA) testing in the management of stage II-III CRC as well as the role of the pathologist in this setting.

Abstract Background Considering the previous research that suggested that screen time (ST), sleep duration, physical activity (PA), obesity and cardiometabolic risk factors are related, it is essential to identify how these variables are associated over time, to provide knowledge for the development of intervention strategies to promote health in pediatric populations. Also, there is a lack of studies examining these associations longitudinally. The aims of the present study were: (1) to investigate the longitudinal relationships between ST, sleep duration, leisure PA, body mass index (BMI), and cardiometabolic risk score (cMetS) in children and adolescents; and (2) to verify scores and prevalence of cMetS risk zones at baseline and follow-up. Methods This observational longitudinal study included 331 children and adolescents (aged six to 17 years; girls = 57.7%) from schools in a southern city in Brazil. ST, sleep duration, and leisure PA were evaluated by a self-reported questionnaire. BMI was evaluated using the BMI z-scores (Z_BMI). The cMetS was determined by summing sex- and age-specific z-scores of total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio, triglycerides, glucose, and systolic blood pressure and dividing it by four. A two-wave cross-lagged model was implemented. Results ST, sleep duration, and leisure PA were not associated with cMetS after 2-years. However, it was observed that higher ST at baseline was associated with shorter sleep duration at follow-up (B=-0.074; 95%IC=-0.130; -0.012), while higher Z_BMI from baseline associated with higher cMetS of follow-up (B = 0.154; 95%CI = 0.083;0.226). The reciprocal model of relationships indicated that the variance of ST, sleep time, leisure PA, Z_BMI, and cMetS explained approximately 9%, 14%, 10%, 67% and 22%, respectively, of the model. Individual change scores and prevalence indicated that cMetS had individual changes from 2014 to 2016. Conclusion Sleep duration, ST and leisure PA were not associated with cMetS after 2 years. ST showed an inverse association with sleep duration, and Z_BMI was positively associated with cMetS after a 2-year follow-up. Finally, the prevalence of no clustering of risk factors increased after two years. These findings suggest the need to promote healthy lifestyle habits from childhood and considering individual factors that can influence cardiometabolic health in children and adolescents.

Abstract Background Nuts consumption is related to cardioprotective effects on primary cardiovascular prevention, but studies conducted in secondary prevention are small, scarce and controversial. The objective of this trial was to evaluate the effects of a regional and sustainable cardioprotective diet added or not with an affordable mixed nuts on cardiometabolic features in patients with previous myocardial infarction. Methods DICA-NUTS study is a national, multi-center, and superiority-parallel randomized clinical trial. Males and females over 40 years old diagnosed with previous myocardial infarction in the last 2 to 6 months were included. Patients were allocated into two groups: the Brazilian Cardioprotective diet (DICA Br) supplemented with 30 g/day of mixed nuts (10 g of peanuts; 10 g of cashew; 10 g of Brazil nuts) (intervention group, n = 193); or only DICA Br prescription (control group, n = 195). The primary outcome was low-density lipoprotein cholesterol means (in mg/dL) after 16 weeks. Secondary outcomes were other lipid biomarkers, glycemic and anthropometric data and diet quality. Results After adjustment for baseline values, participating study site, time since myocardial infarction and statin treatment regimen (high potency, moderate and low potency/no statins), no significant difference was found between the groups in low-density lipoprotein cholesterol concentrations (intervention-control difference: 3.48 mg/dL [-3.45 to 10.41], P = 0.32). Both groups improved their overall diet quality at the end of the study without differences between them after 16 weeks (intervention-control difference: 1.05 (-0.9 to 2.99); P = 0.29). Other lipids, glycemic profile and anthropometrics were also not different between study groups at the end of the study. Conclusion Adding 30 g/day of mixed nuts to the DICA Br for 16 weeks did not change lipid, glycemic and anthropometric features in the post-myocardial infarction setting. Trial registration This study is registered on ClinicalTrials.gov website under number NCT03728127 and its World Health Organization Universal Trial Number (WHO-UTN) is U1111-1259–8105.

Abstract We describe the geographical variation in tree species composition across Amazonian forests and show how environmental conditions are associated with species turnover. Our analyses are based on 2023 forest inventory plots (1 ha) that provide abundance data for a total of 5188 tree species. Within-plot species composition reflected both local environmental conditions (especially soil nutrients and hydrology) and geographical regions. A broader-scale view of species turnover was obtained by interpolating the relative tree species abundances over Amazonia into 47,441 0.1-degree grid cells. Two main dimensions of spatial change in tree species composition were identified. The first was a gradient between western Amazonia at the Andean forelands (with young geology and relatively nutrient-rich soils) and central–eastern Amazonia associated with the Guiana and Brazilian Shields (with more ancient geology and poor soils). The second gradient was between the wet forests of the northwest and the drier forests in southern Amazonia. Isolines linking cells of similar composition crossed major Amazonian rivers, suggesting that tree species distributions are not limited by rivers. Even though some areas of relatively sharp species turnover were identified, mostly the tree species composition changed gradually over large extents, which does not support delimiting clear discrete biogeographic regions within Amazonia.

Abstract Background This study aims to verify the relationship between screen and sleep time, body mass index (BMI) and immunological factors with telomere length according to leisure-time physical activity (PA) in children and adolescents. Methods A cross-sectional study involving a sample of 476 schoolchildren of both sexes, aged seven to 17 years, from a community in southern Brazil. Behavioral variables (PA, sleep time, and screen time) were self-reported using a questionnaire. PA was classified as inactive and any PA (doing some physical activity). The associations of screen time, sleep time, BMI, and immunologic factors with telomere length were tested using multiple linear regression models, with the sample divided according to the schoolchildren’s leisure-time physical activity practices. Results An inverse association between BMI and telomere length (β: -0.239; 95% CI: -0.468; -0.010) and a direct association of leukocytes (β: 0.151; 95% CI: 0.029; 0.278) and neutrophils (β: 0.131; 95% CI: 0.008; 0.254) with telomeres were found in the inactive students. No association was found between screen time and sleep time and telomeres. No association was found among students who engaged in any PA. Conclusion The associations between telomeres, BMI, and immunologic factors were found only in inactive students. These results suggest that the association between BMI and immunological factors and telomere length may be influenced by physical activity.

Abstract Aims The use of loop diuretics in pulmonary arterial hypertension (PAH) is less frequent compared with heart failure. The clinical and prognostic characteristics of PAH patients according to loop diuretic use remain unexplored. In this study, we retrospectively analysed the characteristics and survival of PAH patients requiring different doses of loop diuretics. Methods and results Patients diagnosed with PAH between 2001 and 2022 at seven European centres for the management of PAH. According to the median equivalent dose of furosemide in the overall cohort, patients were divided into two subgroups: no/low‐dose loop diuretic and high‐dose loop diuretic. Primary outcome was 5 year all‐cause mortality. Among the 397 patients included, 227 (57%) were treated with loop diuretics. Median daily furosemide equivalent dose was 25 mg, and accordingly patients were divided in no/low dose (i.e. ≤25 mg, n = 257, 65%) vs. high dose (i.e. >25 mg, n = 140, 35%). Patients in the high‐dose group were older, more likely to have comorbidities, and had a more severe disease according to the ESC/ERS risk category. Crude 5 year survival was significantly shorter in patients in the high‐dose group, but after adjustment for age, sex, and risk category, high loop diuretic dose was not significantly associated with the primary outcome. Conclusions Use of high dose of loop diuretics in PAH is associated with a higher burden of comorbidities, more severe disease, and worse survival. However, in PAH, the need of high loop diuretic dose is a marker of disease severity and not an independent prognostic factor.

Ultimamente o Cerrado brasileiro tem sido muito estudado, principalmente devido a sua diversidade de frutas exóticas, que apresentam um grande potencial tecnológico. O objetivo deste trabalho foi avaliar o efeito da variação nos parâmetros de extração (temperatura, tempo, solvente e utilização do equipamento de ultrassom) de antioxidantes provenientes do fruto da cagaita in natura, por meio da quantificação da capacidade antioxidante. O tratamento 3 (60 minutos a 70 °C, com água como solvente extrator e sem a utilização do ultrassom) foi o que teve maior significância em todas as análises para quantificação de antioxidantes (DPPH, FRAP, ABTS e teor de compostos fenólicos). A sustentabilidade do processo é justificada, pois a água foi o melhor solvente e a não utilização do ultrassom simplifica o processo de extração. A cagaita mostrou ser um fruto promissor para a indústria alimentícia como matéria-prima, e sua melhor extração foi simples e de baixo custo, facilitando o emprego dessa tecnologia.

Creutzfeldt-Jakob disease (CJD) is a rare spongiform encephalopathy characterized by a rapid neurodegenerative progress, caused by a misfolded variant of the cellular prion protein (PrP) known as PrPSc. The clinical presentation of sCJD includes a wide range of neurological signs of cortical, subcortical, or cerebellar origin, either isolated or in various combinations. Due to this protean clinical presentation form, sCJD must be distinguished from other dementias. In this case report, we discuss the Heidenhain variant of Creutzfeldt-Jakob disease (HvCJD), a rare variant characterized by early visual symptoms and typical findings in imaging scans. Our patient presented rapidly progressive dementia and a history of visual hallucinations. As for other prion diseases, only symptomatic treatment is available for HvCJD. Thirty years of clinical investigation of patients with prion disease have resulted in little progress in either defining or evaluating potential treatments.

OBJECTIVES: To identify and evaluate the effect of cognitive stimulation (CS) interventions for older adults with dementia on caregivers’ health. METHOD: This systematic literature review was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA) guidelines. A search was performed by two independent researchers in May 2018, using Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Science Literature Database (LILACS), Physiotherapy Evidence Database (PEDro), PsycINFO, and PubMed databases. The terms used were "dementia" AND "cognitive stimulation" and their equivalents in Portuguese and Spanish. For inclusion, articles should have been experimental, published from January 2007 to April 2018, with CS delivered to older adults with dementia by a professional or by a caregiver, and outcome measured in the caregiver. Quality of selected studies was assessed using the PEDro scale. RESULTS: The sample consisted of 10 studies, and only two reported CS benefits to the health of caregivers of older adults with dementia. CONCLUSION: This study found no consistent evidence of actual benefits of CS in older adults with dementia to their caregivers’ health.

Abstract Background To verify the influence of macrogeometry with healing chambers on the osseointegration of dental implants by analyzing implant stability quotient (ISQ) and evaluate the correlation between insertion torque and ISQ insertion with different macrogeometries. Methods In total, 26 implants were installed in the posterior mandible of eight patients with sufficient bone height for the installation of implants measuring 3.5 mm in diameter and 9.0 mm in length. The implants were categorized according to two types of macrogeometry: a test group (GT) with 13 conical implants with healing chambers and a control group (GC) with 13 conical implants with conventional threads. To insert the implants, a bone drilling protocol was used up to a diameter of 3 mm with the last helical bur. The insertion torque of the implants was evaluated, followed by the measurement of ISQ at 0 (T-0), 7 (T-7), 14 (T-14), 21 (T-21), 28 (T-28), and 42 (T-42) days. Results The mean insertion torque was 43 Ncm in both groups, without a significant difference. Moreover, no significant difference in the ISQ values was found between the groups at different time points (p > 0.05), except at T-7 (GT = 69.87±1.89 and GC = 66.48±4.49; p = 0.01). Although there was no significant difference, ISQ median values were higher in the GT group than GC group at 28 days (GT = 67.98 and GC = 63.46; p = 0.05) and 42 days (GT = 66.12 and GC = 60.33; p = 0.09). No correlation was found between the insertion torque and ISQ insertion (p > 0.05). Conclusion Furthermore, implants with a 3.5 mm diameter macrogeometry, with or without healing chambers, inserted with a drilling protocol up to 3 mm in diameter of the last helical bur, led to a similar secondary stability, with no difference in ISQ values. Although, implants with healing chamber demonstrates ascending values in the graph of ISQ, having a trend of faster osseointegration than implants without healing chambers. Both macrogeometries provide a similar primary stability to implants. Trial registration This study was registered retrospectively in ReBec (brazilian registry of clinical trials) under the number RBR-96n5×69, on the date of 19/06/2023.

Dental guards are customized oral devices used to protect teeth and treat various oral cavity conditions. They are made from durable materials and individually tailored to perfectly fit patients’ dental arches. Dental guards are crucial in managing bruxism, a condition characterized by teeth grinding that can lead to tooth wear and sensitivity. They act as a protective barrier, evenly distributing pressure and preventing tooth damage. Additionally, dental guards are used to alleviate symptoms of temporomandibular joint (TMJ) disorders, aiding in jaw repositioning and reducing facial pain. Furthermore, they are indispensable in contact sports, protecting teeth and oral tissues from injuries. Thus, dental guards play a crucial role in maintaining oral health and overall well-being, providing protection and relieving discomfort in various situations.

Abstract Background Laboratory diagnosis of American cutaneous leishmaniasis (ACL) requires a tool amenable to the epidemiological status of ACL in Brazil. Montenegro skin test (MST), an efficient immunological tool used for laboratory diagnosis of ACL, induces delayed-type hypersensitivity (DTH) response to the promastigote antigens of Leishmania; however, human immune responses against infection are modulated by the amastigote of the parasite. Leishmania (V.) lainsoni induces strong cellular immunity in humans; therefore, the antigenic reactivity of its axenic amastigote (AMA antigen) to MST was evaluated for the laboratory diagnosis of ACL. Methods Among 70 individuals examined, 60 had a laboratory-confirmed diagnosis of ACL; 53 had localized cutaneous leishmaniasis (LCL), and 7 had mucosal leishmaniasis (ML). Patients were treated at the Evandro Chagas Institute’s leishmaniasis clinic, Pará State, Brazil. Ten healthy individuals with no history of ACL (control group) were also examined. Leishmania (V.) braziliensis promastigote antigen (PRO) was used to compare the reactivity with that of AMA antigen. Paired Student’s t-test, kappa agreement, and Spearman test were used to evaluate the reactivity of AMA and PRO. Results The mean reactivity of AMA in ACL patients was 19.4 mm ± 13.3, which was higher (P

Abstract This study aims to (1) compare the kinetics of pulmonary oxygen uptake (VO2p), skeletal muscle deoxygenation ([HHb]), and microvascular O2 delivery (QO2mv) between heart failure (HF) patients with reduced ejection fraction (HFrEF) and those with preserved ejection fraction (HFpEF), and (2) explore the correlation between body composition, kinetic parameters, and exercise performance. Twenty-one patients (10 HFpEF and 11 HFrEF) underwent cardiopulmonary exercise testing to assess VO2 kinetics, with near-infrared spectroscopy (NIRS) employed to measure [HHb]. Microvascular O2 delivery (QO2mv) was calculated using the Fick principle. Dual-energy X-ray absorptiometry (DEXA) was performed to evaluate body composition. HFrEF patients exhibited significantly slower VO2 kinetics (time constant [t]: 63 ± 10.8 s vs. 45.4 ± 7.9 s; P

Background: Differentiated thyroid carcinoma (DTC), mainly papillary (PTC), at low risk of recurrence is currently managed with active surveillance strategies or less aggressive surgeries. However, total thyroidectomy with 131I treatment is still performed both if these tumors are diagnosed before or occasionally after surgery. This real-life study aimed to evaluate the rate of biochemical, structural, and functional events in a large series of consecutive DTCs at low risk of recurrence treated by total thyroidectomy, but not with 131I, in a medium–long-term follow-up. Patients and Methods: We evaluated clinical–pathologic data of 383 consecutive patients (2006–2012) with unifocal DTC [T1a/b(s)] at low risk of recurrence, treated with total thyroidectomy but without lymph node dissection and 131I treatment after surgery. We evaluated if structural, biochemical, and functional events were detected during the follow-up. Results: Females accounted for 75.7% of our study group, and the median age was 50 years. The median tumor dimension was 0.4 cm (range 0.1–1.2). Most of the patients had a unifocal T1a tumor (98.9%), and 73.6% had a classic variant of PTC. We divided the patients according to the absence (group A—n = 276) or presence (group B—n = 107) of interfering TgAb at first control after surgery. After a median follow-up of 10 years, no structural events were detected. Sixteen out of three hundred and eighty-three (4.2%) patients developed biochemical events: 12/276 (4.3%) in group A and 4/107 (3.7%) in group B. The median time elapsed from surgery to detecting a biochemical event was 14.5 and 77.5 months in groups A and B, respectively. No patients performed additional treatments and were followed up with an active surveillance strategy. Conclusions: This study confirmed that patients with DTC at low risk of recurrence showed an excellent outcome in a medium long-term follow-up since no structural events were diagnosed. Significant variations in Tg/TgAb were detected in a few cases, all managed with an active surveillance strategy without the need for other treatments. Therefore, a relaxed follow-up with neck ultrasound and Tg/TgAb measurement is enough to early identify those very unusual cases of recurrence.

Abstract Background Tuberous sclerosis complex (TSC) is a multisystem neurocutaneous syndrome with variable phenotypes. Recent updates of TSC diagnostic criteria reaffirmed the defined genetic diagnostic criterion as the finding of a pathogenic DNA alteration in either TSC1 or TSC2 genes. It also slightly modified definite clinical diagnostic criteria. TSC-associated skin lesions in infancy are important clinical signs to select individuals with possible TSC for a closer clinical follow-up and genetic testing. Objective To raise awareness of the updated TSC diagnosis criteria; to assess the frequency of skin lesions in TSC patients as well as the first dermatological presentation; and to associate the findings with either TSC1 or TSC2 mutations. Methods Observational cross-sectional study. Clinical and genetic data were retrospectively collected from 37 TSC patients from a Brazilian University Hospital. Patients with skin signs were examined and prospectively assessed for 12 months. Results The earliest cutaneous lesions were hypomelanotic macules, which together with angiofibromas were the most frequent dermatological lesions. The total pathogenic DNA alteration ratio between TSC2 and TSC1 genes was 8:1. The frequency of a TSC2 pathogenic variant was 10-fold greater in the presence of ungual fibromas. Study limitations Small sample and a limited number of patients with TSC1 pathogenic variants. Conclusion Clinicians should be knowledgeable about TSC updated diagnostic criteria. Patients need to be followed up by a multidisciplinary team and treated accordingly. Early detection of cutaneous lesions is important for TSC diagnosis. A significant association between TSC2 gene pathogenic alterations and ungual fibromas is described.

Abstract Background Merkel cell polyomavirus (MCPyV), a human polyomavirus that is unequivocally linked to merkel cell carcinoma (MCC), has been found in association with keratinocytes carcinomas (KC), especially basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC). Nevertheless, there is scarce information about the possible involvement of MCPyV in the development of KC. Objectives To assess the presence of MCPyV DNA and Large-T Antigen (LT-Ag) via Polymerase Chain Reaction (PCR) and Immunohistochemistry (IHC) in cases of KC, and to correlate its presence with immunohistochemical markers p16, p53, and ki67, tumor type and subtype, sun-exposed location, and epidemiological data. Methods The prevalence of MCPyV DNA, LT-Ag, and immunohistochemical markers p16, p53, and ki67 was assessed by PCR and Immunohistochemistry (IHC) in 127 cases of KC, these results were correlated with tumor type and subtype, sun-exposed location, and epidemiological data. Results The MCPyV DNA was detected in 42.57% (43 of 101) cases by PCR, the LT-Ag was detected in 16.4% (20 of 122) of cases, p16 in 81.5% (97 of 119), p53 in 66.4% (83 of 125), ki67 in 89% (73 of 82). No correlation between MCPyV LT-Ag and DNA confronted with tumor type, subtype, location site, and immunohistochemical markers was found. A single correlation between the MCPyV LT-Ag and cSCC tumors and peri-tumoral lymphocyte cells was noted. Study limitations Further steps need to be taken to better evaluate the MCPyV influence and its possible role in KC carcinogenesis, as the evaluation of the virus genome state, the gene sequence that encodes LT-Ag in the KC tumor cells, and in situ hybridization for viral DNA or RNA in these cells. Conclusions Despite the frequent detection of MCPyV in KC, the data available so far does not support the hypothesis of a causal relationship between them.

Abstract Many of the energy systems functioning across the developing world are poorly designed and largely inadequate to meet a country's commercial and domestic energy needs. This is especially so in Latin America, where poverty trends have been exacerbated by limited access to energy, which could be used towards supporting industrial and small-scale commercial activities. This has characterised the widespread trend of energy poverty. This phenomenon poses a major barrier towards achieving the UN Sustainable Development Goals (SDGs) and addressing climate change, since lack of access to reliable energy generation systems hinders the development of economic activities and limits the comfort of living conditions. This paper reports on a study aimed at catering to a better understanding of the challenges related to energy poverty in Latin America and identifying some of the tools that may be deployed to address them. The methodological procedures used were bibliometric analysis and survey. The main findings of this research evidence that reducing energy poverty in Latin American countries is crucial to alleviating household costs since a considerable part of family income is used to pay the energy needs. Less use of coal, greater access to electricity—including those from renewable generation—as well as the use of technologies and programs subsidized by governments would significantly contribute to increasing the Latin American citizens' quality of life and achieving the SDGs.

Abstract Background The use of antiretrovirals has increased the survival of People Living with HIV/AIDS (PLWHA), resulting in an aging population and a rise in the incidence of sarcopenia. The lack of uniformity among the prevalences found in studies may be associated with the use of different diagnostic criteria, highlighting the need for local studies to determine the prevalence of sarcopenia. Methods Cross-sectional study to estimate the prevalence and associated factors of sarcopenia using the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). This study included PLWHA of both sexes, aged 40 years or older, who were treated at the infectious disease outpatient clinic of a tertiary hospital from 2019 to 2021. Muscle mass was quantified through electrical bioimpedance, using resistance and reactance to calculate appendicular lean mass (ALM) in kg/m². Muscle strength, measured in kg, was assessed using a manual dynamometer, and muscle function was evaluated using the gait speed test (m/s). Numerical variables were analyzed using measures of central tendency and dispersion. The chi-square test was used to assess associations in categorical variables. Odds ratios (OR) and 95% Confidence Intervals (CI) were calculated to evaluate the strength of associations. Results Among the 218 PLWHA, the prevalence of sarcopenia was 8.7% (95% CI: 5.6 to 13.3). The mean age of the study population was 51.8 ± 8.3 years; 53.7% were male, 72.9% were brown/Black, 97.7% reported not using illicit drugs, and 24.8% were classified as obese. Multivariate analysis showed that the time since HIV diagnosis (P = 0.022) and the use of illicit drugs were associated with the diagnosis of sarcopenia. Conclusion The prevalence of sarcopenia using the EWGSOP2 criteria was low. People with a longer duration of HIV infection and those using illicit drugs were more likely to develop sarcopenia.

Abstract Background African mahogany species (Khaya sp.) have been introduced to Brazil gaining increasing economic interest over the last years, as they produce high quality wood for industrial applications. To this date, however, the knowledge available on the genetic basis of African mahogany plantations in Brazil is limited, which has driven this study to examine the extent of genetic diversity and structure of three cultivated species (Khaya grandifoliola, Khaya senegalensis and Khaya ivorensis) and their prospects for forest breeding. Results In total, 115 individuals were genotyped (48 of K. grandifoliola, 34 of K. senegalensis and 33 of K. ivorensis) for 3,330 filtered neutral loci obtained from genotyping-by-sequencing for the three species. The number of SNPs varied from 2,951 in K. ivorensis to 4,754 in K. senegalensis. Multiloci clustering, principal component analysis, Bayesian structure and network analyses showed a clear genetic separation among the three species. Structure analysis also showed internal structure within each species, highlighting genetic subgroups that could be sampled for selecting distinct genotypes for further breeding, although the genetic distances are moderate to low. Conclusion In our study, SNP markers efficiently assessed the genomic diversity of African mahogany forest plantations in Brazil. Our genetic data clearly separated the three Khaya species. Moreover, pairwise estimates of genetic distances among individuals within each species showed considerable genetic divergence among individuals. By genotyping 115 pre-selected individuals with desirable growth traits, allowed us not only to recommend superior genotypes but also to identify genetically distinct individuals for use in breeding crosses.

Abstract We evaluated the prevalence of pathogenic/likely pathogenic germline variants (PGV) in Brazilian pancreatic adenocarcinoma (PC) patients, that represent a multiethnic population, in a cross-sectional study. We included 192 PC patients unselected for family history of cancer. We evaluated a panel of 113 cancer genes, through genomic DNA sequencing and 46 ancestry-informative markers, through multiplex PCR. The median age was 61 years; 63.5% of the patients presented disease clinical stages III or IV; 8.3% reported personal history of cancer; 4.7% and 16.1% reported first-degree relatives with PC or breast and/or prostate cancer, respectively. Although the main ancestry was European, there was considerable genetic composition admixture. Twelve patients (6.25%) were PGV carriers in PC predisposition genes (ATM, BRCA1, BRCA2, CDKN2A, MSH2, PALB2) and another 25 (13.0%) were PGV carriers in genes with a limited association or not previously associated with PC (ACD, BLM, BRIP1, CHEK2, ERCC4, FANCA, FANCE, FANCM, GALNT12, MITF, MRE11, MUTYH, POLE, RAD51B, RAD51C, RECQL4, SDHA, TERF2IP). The most frequently affected genes were CHEK2, ATM and FANC. In tumor samples from PGV carriers in ACD, BRIP1, MRE11, POLE, SDHA, TERF2IP, which were examined through exome sequencing, the main single base substitutions (SBS) mutational signature was SBS1+5+18, probably associated with age, tobacco smoking and reactive oxygen species. SBS3 associated with homologous repair deficiency was also represented, but on a lower scale. There was no difference in the frequency of PGV carriers between: (a) patients with or without first-degree relatives with cancer; and (b) patients with admixed ancestry versus those with predominantly European ancestry. Furthermore, there was no difference in overall survival between PGV carriers and non-carriers. Therefore, genetic testing should be offered to all Brazilian pancreatic cancer patients, regardless of their ancestry. Genes with limited or previously unrecognized associations with pancreatic cancer should be further investigated to clarify their role in cancer risk.

Abstract In swine farming, animals develop diseases that require the use of antibiotics. In-feed antibiotics as growth promoters have been banned due to the increasing concern of antimicrobial resistance. Seaweeds offer bioactive molecules with antibacterial and antioxidant properties. The aim was to estimate the in vitro properties of seaweed extracts: Ascophyllum nodosum (AN), Palmaria palmata (PP), Ulva lactuca (UL), and 1:1 mixes (ANPP, ANUL, PPUL). Escherichia coli strains were used to test for growth inhibitory activity, and chemical-based assays were performed for antioxidant properties. The treatments were 2 (with/without Escherichia coli) × 2 (F4 + and F18 +) × 5 doses (0, 1.44, 2.87, 5.75, 11.50, and 23.0 mg/mL). Bacteria were supplemented with seaweed extracts, and growth was monitored. The antioxidant activity was assessed with 6 doses (0, 1, 50, 100, 200, 500, and 600 mg/mL) × 6 compounds using two chemical assays. Data were evaluated through SAS. The results showed that AN and UL significantly inhibited (p

Abstract Backgrounds This study delves into the risk perceptions of Italian pediatricians concerning climate change's impact on children's health. Given children's heightened vulnerability to climate-related health risks, comprehending these perceptions is crucial. A review of pertinent literature establishes the framework, emphasizing six key factors influencing children's susceptibility to climate-related health hazards. Methods Methodologically, the study utilized a survey tool developed collaboratively with the Italian Society of Pediatrics (SIP), garnering responses from a representative sample of Italian pediatricians. Results Findings indicate a high level of awareness among respondents regarding climate change and its health implications, with a majority attributing it primarily to human activity. Pediatricians recognize various current and anticipated health impacts of climate change, notably concerning illnesses linked to outdoor air quality. Despite acknowledging their role in addressing climate-related health concerns, respondents also cite barriers to engagement, including time constraints and knowledge gaps. However, they express interest in resources like professional training and policy statements to bolster their capacity for effective communication and advocacy. Conclusions Comparisons with prior studies highlight the consistency of findings across diverse contexts and underscore the significance of integrating climate and environmental health education into medical training. Overall, this study sheds light on pediatricians' perspectives in tackling the convergence of climate change and children's health, pinpointing avenues for enhancing their involvement in climate advocacy and mitigation efforts.

Abstract Background Altered meal timing patterns can disrupt the circadian system and affect metabolism. Our aim was to describe sex-specific chrono-nutritional patterns, assess their association with body mass index (BMI) and investigate the role of sleep in this relationship. Methods We used the 2018 questionnaire data from the population-based Genomes for Life (GCAT) (n = 7074) cohort of adults aged 40–65 in Catalonia, Spain, for cross-sectional analysis and its follow-up questionnaire data in 2023 (n = 3128) for longitudinal analysis. We conducted multivariate linear regressions to explore the association between mutually adjusted meal-timing variables (time of first meal, number of eating occasions, nighttime fasting duration) and BMI, accounting for sleep duration and quality, and additional relevant confounders including adherence to a Mediterranean diet. Finally, cluster analysis was performed to identify chrono-nutritional patterns, separately for men and women, and sociodemographic and lifestyle characteristics were compared across clusters and analyzed for associations with BMI. Results In the cross-sectional analysis, a later time of first meal (β 1 h increase = 0.32, 95% CI 0.18, 0.47) and more eating occasions (only in women, β 1 more eating occasion = 0.25, 95% CI 0.00, 0.51) were associated with a higher BMI, while longer nighttime fasting duration with a lower BMI (β 1 h increase=-0.27, 95% CI -0.41, -0.13). These associations were particularly evident in premenopausal women. Longitudinal analyses corroborated the associations with time of first meal and nighttime fasting duration, particularly in men. Finally, we obtained 3 sex-specific clusters, that mostly differed in number of eating occasions and time of first meal. Clusters defined by a late first meal displayed lower education and higher unemployment in men, as well as higher BMI for both sexes. A clear “breakfast skipping” pattern was identified only in the smallest cluster in men. Conclusions In a population-based cohort of adults in Catalonia, we found that a later time of first meal was associated with higher BMI, while longer nighttime fasting duration associated with a lower BMI, both in cross-sectional and longitudinal analyses.

Abstract Background Studies have identified individual blood biomarkers associated with chronic obstructive pulmonary disease (COPD) and related phenotypes. However, complex diseases such as COPD typically involve changes in multiple molecules with interconnections that may not be captured when considering single molecular features. Methods Leveraging proteomic data from 3,173 COPDGene Non-Hispanic White (NHW) and African American (AA) participants, we applied sparse multiple canonical correlation network analysis (SmCCNet) to 4,776 proteins assayed on the SomaScan v4.0 platform to derive sparse networks of proteins associated with current vs. former smoking status, airflow obstruction, and emphysema quantitated from high-resolution computed tomography scans. We then used NetSHy, a dimension reduction technique leveraging network topology, to produce summary scores of each proteomic network, referred to as NetSHy scores. We next performed a genome-wide association study (GWAS) to identify variants associated with the NetSHy scores, or network quantitative trait loci (nQTLs). Finally, we evaluated the replicability of the networks in an independent cohort, SPIROMICS. Results We identified networks of 13 to 104 proteins for each phenotype and exposure in NHW and AA, and the derived NetSHy scores significantly associated with the variable of interests. Networks included known (sRAGE, ALPP, MIP1) and novel molecules (CA10, CPB1, HIS3, PXDN) and interactions involved in COPD pathogenesis. We observed 7 nQTL loci associated with NetSHy scores, 4 of which remained after conditional analysis. Networks for smoking status and emphysema, but not airflow obstruction, demonstrated a high degree of replicability across race groups and cohorts. Conclusions In this work, we apply state-of-the-art molecular network generation and summarization approaches to proteomic data from COPDGene participants to uncover protein networks associated with COPD phenotypes. We further identify genetic associations with networks. This work discovers protein networks containing known and novel proteins and protein interactions associated with clinically relevant COPD phenotypes across race groups and cohorts.

Abstract High-latitude ecosystems have been overlooked in carbon budgets, which traditionally focus on mangroves, salt marshes, and seagrasses. The benthic assemblages and their Nature Contributions to People in Namuncurá – Burdwood Bank I and II, two offshore sub-Antarctic Marine Protected Areas (MPAs), are the conservation values. Here we show that the carbon reservoirs of these MPAs can be greater than those of their Antarctic counterparts, which, together with their extension, emphasize the need to maintain their protected status. Considering their total area, these MPAs stored in biomass 52,085.78 Mg C, corresponding 34,964.16 Mg to organic carbon (OC) and 17,121.62 Mg to inorganic carbon (IC). Surficial sediments stored 933,258,336 Mg C with 188,089,629 Mg of OC and 745,168,707 Mg of IC. However, when accounting for CO2 production through CaCO3 precipitation, the IC fractions decrease to 3,150.37 Mg C and 137,111,042 Mg C for biomass and sediments, respectively. We assume low sediment deposition due to the oceanic location, as direct sedimentation rates for these areas are unavailable. Most blue carbon assessments have focused solely on OC, despite the formation of CaCO3 releases CO2, decreasing net carbon storage. We compared various approaches for incorporating carbonates into carbon estimations. These results underscore the importance of including IC into carbon assessments and highlights the importance of sub-Antarctic benthic ecosystems as nature-based solutions to climate change.

Background Central neuropathic poststroke pain (CNPSP) affects up to 12% of patients with stroke in general and up to 18% of patients with sensory deficits. This pain syndrome is often incapacitating and refractory to treatment. Brain computed tomography and magnetic resonance imaging (MRI) are widely used methods in the evaluation of CNPSP.

Background: Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity (MVPA). However, using only this cut-off could hide important information. For instance, from a population-level point of view, increasing physical activity for those with no or low physical activity could provide more health benefits than increasing physical activity for those with intermediate levels. Also, including a more sensitive cut-point of ≥1 days per week could be an additional strategy for identifying those with low access/opportunities for physical activity practice. Thus, the current study aims to estimate the prevalence of ≥60 min of MVPA ≥1 days per week among adolescents globally, and to describe any relevant gender inequalities. Methods: We used representative datasets from 146 countries/territories collected between 2003 and 2019. MVPA was self-reported. Participants were grouped into younger (≤14 years old) and older (>14 years old) adolescents. Crude Poisson regression models were used to identify the relative differences in ≥60 min of MVPA ≥1 days per week between boys and girls, and random-effects meta-analysis models were used to identify the pooled estimates. Analyses were stratified by country and region. Results: Approximately 80% of both younger and older adolescents reported ≥60 min of MVPA ≥1 days per week. This prevalence was ≥94% in Europe and Central Asia and North America, while the estimates for the other regions were 14y = 1.09 (95%CI: 1.08‒1.10)). Conclusion: Approximately 8 out of 10 adolescents reported accumulating ≥60 min of MVPA ≥1 days per week, with notable differences between regions. Gender differences were observed in several countries, especially among the oldest adolescents. Priorities for physical activity promotion among adolescents should include increasing access/opportunities for physical activity among those who do not achieve ≥60 min of MVPA ≥1 days per week and reducing gender inequalities.

Abstract Background Movement behaviours, such as sedentary behavior (SB) and physical inactivity, have become a public health issue due to their implications for physical and mental health. The literature indicates that the university environment influences the movement behaviors of university students, and the strategies adopted during the pandemic may have favored a decrease in the practice of physical activity and an increase in the time dedicated to SB in this population. We aimed to evaluate the association of SB and moderate to vigorous leisure-time physical activity (MVPA) with presence of symptoms of mental disorders during the COVID-19 pandemic. Methods This is a multicenter survey conducted with undergraduate students from eight Brazilian universities between October 2021 and February 2022 using an online questionnaire. The outcome variable was symptoms of anxiety and depression, assessed by the Depression, Anxiety, and Stress Scale-21. SB was assessed by total sitting time, being that individuals with ≥ 9 h/day were classified with high SB. The practice of MVPA was evaluated based on weekly frequency, duration, and type of exercise. Subsequently, the ratio between the time spent in MVPA (minutes/day) and the time spent in SB (hours/day) was calculated, being considered as cutoff point was the practice of 2.5 min of MVPA for each sedentary hour. To assess the association between the outcome and explanatory variables, multivariable logistic regression was performed. Results A total of 8,650 students participated in the study, with an average age of 23.9 years (SD: ± 6.34). In the multivariate analysis, the odds of anxiety symptoms [OR: 1.37 (95% CI: 1.24–1.50)] and depression [OR: 1.61 (95% CI: 1.47–1.77)] were higher in individuals with ≥ 9 h of SB per day. In the analysis of the relationship between MVPA and SB, not engaging in 2.5 min of MVPA per hour of SB increases the odds of anxiety symptoms [OR: 1.44 (95% CI: 1.31–1.58)] and depression [OR: 1.74 (95% CI: 1.59–1.92)]. Conclusion The results suggest that SB is a risk factor associated with symptoms of anxiety and depression and that not engaging in MVPA exacerbates the negative effects of SB.

Abstract Background Accurate predictions of animal occurrence in time and space are crucial for informing and implementing science-based management strategies for threatened species. Methods We compiled known, available satellite tracking data for pygmy blue whales in the Eastern Indian Ocean (n = 38), applied movement models to define low (foraging and reproduction) and high (migratory) move persistence underlying location estimates and matched these with environmental data. We then used machine learning models to identify the relationship between whale occurrence and environment, and predict foraging and migration habitat suitability in Australia and Southeast Asia. Results Our model predictions were validated by producing spatially varying accuracy metrics. We identified the shelf off the Bonney Coast, Great Australian Bight, and southern Western Australia as well as the slope off the Western Australian coast as suitable habitat for migration, with predicted foraging/reproduction suitable habitat in Southeast Asia region occurring on slope and in deep ocean waters. Suitable foraging habitat occurred primarily on slope and shelf break throughout most of Australia, with use of the continental shelf also occurring, predominanly in South West and Southern Australia. Depth of the water column (bathymetry) was consistently a top predictor of suitable habitat for most regions, however, dynamic environmental variables (sea surface temperature, surface height anomaly) influenced the probability of whale occurrence. Conclusions Our results indicate suitable habitat is related to dynamic, localised oceanic processes that may occur at fine temporal scales or seasonally. An increase in the sample size of tagged whales is required to move towards developing more dynamic distribution models at seasonal and monthly temporal scales. Our validation metrics also indicated areas where further data collection is needed to improve model accuracy. This is of particular importance for pygmy blue whale management, since threats (e.g., shipping, underwater noise and artificial structures) from the offshore energy and shipping industries will persist or may increase with the onset of an offshore renewable energy sector in Australia.

Pycnodysostosis is a very rare autosomal recessive disease. This disorder presents with osteosclerosis, leading to fragile bones, short stature, craniofacial abnormalities, laryngomalacia, sleep apnea syndrome, and many other findings. Difficulty intubation is very common. In our case, we have a patient scheduled for a plastic surgery on her skull under general anesthesia (GA), but she could not lie in a flat position as this could lead to cyanosis and cardiac arrest. So, we have to intubate her in 45° back-up position. Intubation in positions different from the usual supine one probably because of severe laryngomalacia in this patient is possible but needs skilled anesthesiologists and trained personnel.