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Objective: to map the scientific literature on photobiomodulation and photodynamic therapy in the treatment of pressure injuries., Method: this was a scoping review, as recommended by the Joanna Briggs Institute. It included primary and secondary studies available in full in Portuguese, English and Spanish, published in the last 10 years, from 2014 to 2024, in nine databases., Results: 24 studies were included according to the eligibility criteria. The findings suggest that photobiomodulation and photodynamics can play an important role in tissue repair, size reduction and improvement of clinical indicators in the management of pressure injuries. A diversity of laser types used in photobiomodulation was observed and the most common wavelengths used included 658 nm, 660 nm, 808 nm and 980 nm., Conclusion: the studies identified show that photobiomodulation and photodynamic therapies have promising results in healing, reducing the size of lesions and improving clinical indicators in the treatment of pressure injuries., Background: (1) Light therapies are effective in treating pressure injuries. (2) Optimized healing is a promising result of the therapies studied. (3) Reduction in lesion size is a positive effect of the therapies used. (4) There is clinical improvement shown in the indicators in the studies reviewed.

Introduction: Rheumatic heart disease remains a public health problem, especially in developing countries. The mitral valve (MV) is the main affected cardiac structure, requiring intervention in many cases. The discussion of which is the best option - repair or replacement - is still a controversy., Objective: To compare the survival of patients with rheumatic MV submitted to replacement or repair., Methods: We systematically reviewed the English literature through PubMed®, Literatura Latino-Americana e do Caribe em Ciências da Saúde (or LILACS), Scientific Electronic Library Online (or SciELO), and Google Scholar between January 2021 and February 2022, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (or PRISMA) methodology. Articles with a sample of at least 30 patients who underwent MV replacement or repair were included., Results: Six studies including 2874 patients were analyzed. Most of the patients were female (2001; 69.6%) with a ratio of 2.3:1. The ages ranged from 11 to 66 years. The mean follow-up varied from six to 106 months. In the MV repair group, mortality was 2.5% (62 of 2473) and reoperation was 3.7% (93 of 2473), while in the MV replacement group, mortality was 8.2% (106 of 1291), and 3.6% (54 of 1475) of the patients required reoperation. The patient's survival was similar (85% for repair and 87% for replacement). The main complications post-MV repair or replacement were stroke (1.8%; 2.5%) and endocarditis (0.5%; 1.3%)., Conclusion: The MV repair had lower mortality and fewer complications compared to MV replacement. Reoperation rate and survival are similar.

This study analyzed recent changes in the utilization of allogeneic hematopoietic cell transplantation (HCT) for treatment of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and myeloproliferative diseases (MPDs) and the survival of HCT recipients ≥60 years of age in Brazil. This retrospective registry study included patients who received a first allogeneic HCT from any donor between 2012 and 2023. Of the 6657 patients, 444 (7%) were 60 years of age or older who received grafts from human leukocyte antigen (HLA)-matched related (42%) or unrelated (20%) donors or HLA-haploidentical donors (32%). The proportion of HCT recipients 60 years of age or older increased gradually from 3.2% in 2012 to 16% in 2023 mostly due to the increased use of HLA-haploidentical donors since 2018. Overall survival (OS) at day 100 was 77%, and estimated OS at 12 months was 53% (95% CI, 48%-58%). OS at 12 months was higher for transplants during 2015 to 2017 (58%) and 2018 to 2020 (68%) compared with 2012 to 2014 (45%), but it did not differ for those during 2021 to 2023 (49%). Mortality with HLA-haploidentical donors (HR, 2.35; 95% CI, 1.65-3.34 [P < .001]) and cord blood donors (HR, 4.68; 95%,CI, 1.29-16.9 [P = .01]) was higher than with HLA-matched related donors. Mortality was lower for patients with transplants during the 2015 to 2020 period (HR, 0.57; 95% CI, .34-.96 [.037]) than for those during 2012 to 2014.This study revealed a gradual increase in the use of allogeneic HCT in individuals aged 60 years and older in Brazil. While use of haploidentical donors has increased worldwide, its association with increased mortality in the elderly population warrants caution when considering this treatment., (Copyright © 2024 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)

Brain accumulation of the branched-chain α-keto acids α-ketoisocaproic acid (KIC), α-keto-β-methylvaleric acid (KMV), and α-ketoisovaleric acid (KIV) occurs in maple syrup urine disease (MSUD), an inherited intoxicating metabolic disorder caused by defects of the branched-chain α-keto acid dehydrogenase complex. Patients commonly suffer life-threatening acute encephalopathy in the newborn period and develop chronic neurological sequelae of still undefined pathogenesis. Therefore, this work investigated the in vitro influence of pathological concentrations of KIC (5 mM), KMV (1 mM), and KIV (1 mM) on mitochondrial bioenergetics in the cerebral cortex of neonate (one-day-old) rats. KIC, but not KMV and KIV, decreased phosphorylating (stimulated by ADP) and uncoupled (induced by CCCP) mitochondrial respiration supported by pyruvate, malate, and glutamate, indicating metabolic inhibition. These effects were less evident after supplementing the medium with succinate. KIC also mildly increased non-phosphorylating respiration (in the presence of oligomycin) using pyruvate plus malate or glutamate plus malate as substrates, suggesting an uncoupling effect. Moreover, KIC markedly inhibited the activity of α-ketoglutarate dehydrogenase noncompetitively and decreased ATP synthesis. Finally, docking simulations demonstrated that KIC preferentially interacts with E2 and E3 subunits of α-ketoglutarate dehydrogenase at the dihydrolipoamide binding site and into an allosteric site of E1. The present data strongly indicate that KIC compromises mitochondrial bioenergetics in the neonatal rat brain, supporting the hypothesis that disruption of energy homeostasis caused by brain KIC accumulation in the first days of life may be implicated in the neuropathology of MSUD., Competing Interests: Declarations. Ethical Approval: This research was conducted according to the National Research Council’s Guide for the Care and Use of Laboratory Animals (8th edition, National Academies Press). Additionally, the experimental procedures received approval from the Ethics Committee on the Use of Animals at UFRGS (no 42875). Competing Interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Bed regulation within Brazil's National Health System (SUS) plays a crucial role in managing care for patients in need of hospitalization. In Rio Grande do Norte, Brazil, the RegulaRN Leitos Gerais platform was the information system developed to register requests for bed regulation for COVID-19 cases. However, the platform was expanded to cover a range of diseases that require hospitalization. This study explored different machine learning models in the RegulaRN database, from October 2021 to January 2024, totaling 47,056 regulations. From the data obtained, 12 features were selected from the 24 available. After that, blank and inconclusive data were removed, as well as the outcomes that had values other than discharge and death, rendering a binary classification. Data was also correlated, balanced, and divided into training and test portions for application in machine learning models. The results showed better accuracy (87.77%) and recall (87.77%) for the XGBoost model, and higher precision (87.85%) and F1-Score (87.56%) for the Random Forest and Gradient Boosting models, respectively. As for Specificity (82.94%) and ROC-AUC (82.13%), the Multilayer Perceptron with SGD optimizer obtained the highest scores. The results evidenced which models could adequately assist medical regulators during the decision-making process for bed regulation, enabling even more effective regulation and, consequently, greater availability of beds and a decrease in waiting time for patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Barreto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: This study explores the NodeIdentifyR algorithm (NIRA) as a novel network analysis method for examining Antisocial Personality Disorder (ASPD) traits., Methods: Using a sample of 2230 Brazilian adults (aged 18-73 years) who responded to ASPD-related factors of the Personality Inventory for DSM-5 (PID-5), we applied NIRA to an ASPD network and compared its results with traditional network analysis methods., Results: Our findings revealed that deceitfulness emerged as the most central trait across both methodologies. NIRA provided additional insights, indicating that simulated decreases in the likelihood of irresponsibility reduced the presence of other traits, while a simulated increase in deceitfulness amplified the likelihood of other ASPD pathological traits., Conclusions: Our results suggest that traditional network centrality measures converge with NIRA's simulated increase results, but NIRA's simulated decrease provides additional information not captured by traditional centrality estimates. We recommend further research to validate these findings across different psychopathologies and refine NIRA use in clinical settings. The insights from this study could serve as a foundation for developing targeted interventions and enhancing our understanding of ASPD trait dynamics., (© 2024 Wiley Periodicals LLC.)

Background and Objectives: A large cohort of pediatric patients with various forms of childhood cancer was investigated for the presence of viruses using metagenomics. A total of 476 patient samples, collected between 1989 and 2018, were analyzed, representing various pediatric oncological diagnoses and a control group of non-malignant diagnoses., Study Design: The study was carried out using metagenomic sequencing of serum samples. Viruses were identified and analyzed using bioinformatics methods, followed by Polymerase chain reaction (PCR) confirmation RESULTS: The results indicate that a wide range of viruses can be detected in the bloodstream of children with newly diagnosed cancer. Nine viral genomes were identified: Human Pegivirus (HPgV), Hepatitis C virus, Parechovirus 1, Rhinovirus C, Human papillomavirus 116, Human polyomavirus 10, Parvovirus B19, and different variants of Torque Teno Virus (TTV). In this study, a previously unknown virus was found belonging to the Iflavirdae family in the order Picornavirales. HPGV was significantly more common in patients with leukemia compared to other conditions., Conclusions: These results highlight the abundance of systemic virus infections in children, and the value of metagenomic sequencing for hypothesis forming regarding the associations between virus infections and cancer., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Our research group previously studied the effectiveness of lipid-core nanocapsules (LNC) containing simvastatin (SV-LNC) in treating cognitive impairment in rats. While our results were promising, we needed to evaluate the potential toxicity of the nanoparticles themselves. This study aimed to compare the biochemical and hematological parameters of adult Wistar rats receiving LNC or SV-LNC to those receiving low doses of simvastatin crystals dispersed in a saline solution over 45 days. We discovered that LNC and SV-LNC, which are both nanometers in size with low polydispersity index, negative zeta potential, and high SV encapsulation efficacy, were not more toxic than SV crystals based on various biochemical markers of hepatic, pancreatic, renal, mineral, bony, alkaline phosphatase, glucose, and uric acid damage. Furthermore, LNC exhibited no toxicity for hematological parameters, including red and white blood cell counts. Based on this animal model of toxicological study, our findings suggest that long-term administration of LNC is a safe and promising nanocarrier., Competing Interests: The authors declare that they have no competing interests., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Stimulation of the dorsal half of the rat periaqueductal gray (DPAG) with 60-Hz pulses of increasing intensity, 30-μA pulses of increasing frequency, or increasing doses of an excitatory amino acid elicits sequential defensive responses of exophthalmia, immobility, trotting, galloping, and jumping. These responses may be controlled by voltage-gated calcium channel-specific firing patterns. Indeed, a previous study showed that microinjection of the DPAG with 15 nmol of verapamil, a putative blocker of L-type calcium channels, attenuated all defensive responses to electrical stimulation at the same site as the injection. Accordingly, here we investigated the effects of microinjection of lower doses (0.7 and 7 nmol) of both verapamil and mibefradil, a preferential blocker of T-type calcium channels, on DPAG-evoked defensive behaviors of the male rat. Behaviors were recorded either 24 h before or 10 min, 24 h, and 48 h after microinjection. Effects were analyzed by both threshold logistic analysis and repeated measures analysis of variance for treatment by session interactions. Data showed that the electrodes were all located within the dorsolateral PAG. Compared to the effects of saline, verapamil significantly attenuated exophthalmia, immobility, and trotting. Mibefradil significantly attenuated exophthalmia and marginally attenuated immobility while facilitating trotting. While galloping was not attenuated by either antagonist, jumping was unexpectedly attenuated by 0.7 nmol verapamil only. These results suggest that T-type calcium channels are involved in the low-threshold freezing responses of exophthalmia and immobility, whereas L-type calcium channels are involved in the trotting response that precedes the full-fledged escape responses of galloping and jumping., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: To assess the effective and organ/tissue equivalent radiation doses of different scout projection protocols in four CBCT units., Methods: Optically stimulated luminescence dosimeters (OSLD) were placed in reference anatomical locations in the head and neck segments of an anthropomorphic phantom representing an average adult male. Ten repeated exposures were obtained from each of the twelve scout projections studied, acquired from four maxillofacial cone beam computed tomography (CBCT) units (Midmark EIOS, 3D Accuitomo F170, Veraviewepocs 3D R100, and Veraview X800). The effective and organ/tissue equivalent doses were calculated for each protocol., Results: Effective doses ranged from 0.7 µSv (Accuitomo F170 60 × 60 mm-anterior maxilla) to 6.9 µSv (Midmark 50 × 50 mm-anterior maxilla). The highest organ/tissue equivalent doses were recorded for the oral mucosa and salivary glands; however, the thyroid was the highest contributor to the effective dose, followed by the salivary glands., Conclusions: Despite some variability among CBCT machines and protocols, the acquisition of scout projections is a low-dose procedure. The use of scout projections to ensure an adequate position of the region of interest within the field of view is highly desirable as they contribute minimally to overall CBCT patient dose., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The two broad aims of this study were to (a) investigate how the three traits of the triarchic model-boldness, meanness, and disinhibition-relate to compliance with public health measures, as well as to internalizing and externalizing psychopathology, during a public health crisis, and (b) test for associations between psychopathology and compliance with public health measures. Participants were 947 Brazilian adult females aged 18-75 years who completed measures of the triarchic traits, internalizing and externalizing symptoms/problems, and a COVID-19 behaviors and beliefs questionnaire. Multiple regression and path analyses showed meanness to be the only triarchic trait significantly predictive of compliance with public health measures, in a negative direction, when controlling for the other traits. Results also demonstrated that compliance with public health measures was associated with levels of distress (negatively), obsessions/fear (positively), and positive mood (negatively). Overall, the results demonstrate the contributions of the triarchic traits to understanding complex phenomena, highlighting meanness as the most essential triarchic trait predictor of adherence to public health measures among females., (© 2023. National Council for Mental Wellbeing.)

Narcotic Detection Dogs (NDDs) are essential tools in the fight against drug trafficking, acting with high precision and improving efficiency at border posts. When trained efficiently, these dogs can detect a great variety of compounds, such as cocaine, marijuana and its derivatives, and synthetic drugs, among others. Most of the knowledge on canine detection processes and efficiency has been determined in experimentally controlled conditions, but narcotic seizures detected by dogs in realistic anti-drug operations have not yet been critically determined in a Country with continental dimensions such as Brazil. This study aimed to evaluate the data set concerning the performance, operations, efficiency, and success rate of NDDs used by the Brazilian Customs Authority (Aduana) in the fight against drug trafficking. Narcotic seizure rates increased in luggage and packages detected by NDDs working at border crossings from 2010 to 2020, with an estimated value of over US$ 2 billion in losses to the cocaine drug trafficking business. NDD units also increased most narcotic groups seized in the same period. The number of NDDs and anti-drug operations, and Customs Border Post (CBP) influenced the rates of drugs seized. NDDs provided an increase of 3,157 kg/animal of drugs seized for every new dog introduced into the inspection systems., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Jantorno, Xavier, Magalhães, de Castro, McManus and de Melo.)

In the COVID-19 context, traits associated with antisociality can decrease concern and awareness about the potential harmfulness of the virus. This study investigated associations of pathological traits of antisocial personality disorder (ASPD) with behaviours and beliefs linked to COVID-19 containment measures. The sample consisted of 2230 Brazilian adults who answered ASPD-related facets of the Personality Inventory for DSM-5 and a questionnaire regarding adherence to COVID-19 containment measures. We applied the DSM-5 ASPD criteria to divide the sample into antisocial and non-antisocial groups. Our findings suggest that individuals meeting the criteria for ASPD tend to exhibit reduced compliance with pandemic control measures and lower adherence to hygiene practices. Moreover, sex, income, and age should be considered potential covariates in research investigating the relationship between antisocial traits and adherence to COVID-19 preventive measures. Altogether, our findings highlight ASPD traits' role in the predisposition to lack of prosocial behaviours of adherence to COVID-19 containment measures., (© 2023 John Wiley & Sons Ltd.)

The Inventory of Depression and Anxiety Symptoms-Expanded version (IDAS-II) is one of the few tools designed to assess internalizing symptoms based on dimensional models. We conducted two studies, the first testing internal validity aspects of the IDAS-II and the second testing the external validity of the scales. In the first study we adapted the IDAS-II to Brazilian Portuguese and tested its internal structure, including a higher order factorial solution coherent with the internalizing spectrum, the stability of the factor structure, and its measurement invariance for sex and racial groups. Participants were 2,379 Brazilian adults. In the second study, we investigated the IDAS-II scales' associations with broad pathological personality traits in Brazilian ( N = 245) and North American ( N = 402) samples. The results of the first study indicated that the IDAS-II scales are grouped into three first-order factors (Distress, Obsessions/Fear, and Positive Mood), replicating Wester et al. (2022) and Petre et al. (2023). Our results also suggested the plausibility of an internalizing second-order factor for the IDAS-II Brazilian version. The multigroup confirmatory factor analysis shows that this scale is invariant for males and females and for White and Black/Brown people. In the second study, the IDAS-II scales demonstrated mostly coherent associations with broad domains of pathological personality traits. Besides the internal validity of the Brazilian IDAS-II, our results also provide information about its external validity and expand its nomological network, as it is the first study reporting its associations with broad domains of pathological personality traits. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Effective and timely detection is vital for mitigating the severe impacts of Sexually Transmitted Infections (STI), including syphilis and HIV. Cyclic Voltammetry (CV) sensors have shown promise as diagnostic tools for these STI, offering a pathway towards cost-effective solutions in primary health care settings., Objective: This study aims to pioneer the use of Fourier Descriptors (FDs) in analyzing CV curves as 2D closed contours, targeting the simultaneous detection of syphilis and HIV., Methods: Raw CV signals are filtered, resampled, and transformed into 2D closed contours for FD extraction. Essential shape characteristics are captured through selected coefficients. A complementary geometrical analysis further extracts features like curve areas and principal axes lengths from CV curves. A Mahalanobis Distance Classifier is employed for differentiation between patient and control groups., Results: The evaluation of the proposed method revealed promising results with classification performance metrics such as Accuracy and F1-Score consistently achieving values rounded to 0.95 for syphilis and 0.90 for HIV. These results underscore the potential efficacy of the proposed approach in differentiating between patient and control samples for STI detection., Conclusion: By integrating principles from biosensors, signal processing, image processing, machine learning, and medical diagnostics, this study presents a comprehensive approach to enhance the detection of both syphilis and HIV. This setts the stage for advanced and accessible STI diagnostic solutions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that., Methods: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice., Discussion: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals., Trial Registration: https://osf.io/bhncv ., (© 2024. The Author(s).)

Here we introduce a first-in-class microRNA-sensitive oncolytic Zika virus (ZIKV) for virotherapy application against central nervous system (CNS) tumors. The described methodology produced two synthetic modified ZIKV strains that are safe in normal cells, including neural stem cells, while preserving brain tropism and oncolytic effects in tumor cells. The microRNA-sensitive ZIKV introduces genetic modifications in two different virus sites: first, in the established 3'UTR region, and secondly, in the ZIKV protein coding sequence, demonstrating for the first time that the miRNA inhibition systems can be functional outside the UTR RNA sites. The total tumor remission in mice bearing human CNS tumors, including metastatic tumor growth, after intraventricular and systemic modified ZIKV administration, confirms the promise of this virotherapy as a novel agent against brain tumors-highly deadly diseases in urgent need of effective advanced therapies., Competing Interests: Declaration of interests C.K. and O.K.O. are co-founders and equity holders of Vyro Bio Inc. From February 1, 2022, C.K. has been the Chief Scientific Officer of Vyro Bio Inc and inventor on patent applications filed by Vyro Bio Inc. related to the ZIKV genetic engineering. From February 1, 2022, O.K.O. has been a member of the Board of Directors of Vyro Bio Inc. From January 31, 2023, H.B. has been a member of the Scientific Advisory Boards of Vyro Bio Inc. From October 18, 2021, G.M.N. has been an employee of Vyro Bio Inc. From January 11, 2022, T.P.S. has been an employee of Vyro Bio Inc. From January 30, 2022, C.Longo has been an employee of Vyro Bio Inc. From February 22, 2022, P.H.M. has been an employee of Vyro Bio Inc. From March 21, 2022, C.Lima has been an employee of Vyro Bio Inc. From May 10, 2022, D.G.M. has been an employee of Vyro Bio Inc. From August 19, 2022, G.G.O.O. has been an employee of Vyro Bio Inc., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objectives: To assess the effect of standard filtered back projection (FBP) and iterative reconstruction (IR) methods on CBCT image noise and processing time (PT), acquired with various acquisition parameters with and without metal artefact reduction (MAR)., Methods: CBCT scans using the Midmark EIOS unit of a human mandible embedded in soft tissue equivalent material with and without the presence of an implant at mandibular first molar region were acquired at various acquisition settings (milliamperages [4mA-14mA], FOV [5 × 5, 6 × 8, 9 × 10 cm], and resolutions [low, standard, high] and reconstructed using standard FBP and IR, and with and without MAR. The processing time was recorded for each reconstruction. ImageJ was used to analyze specific axial images. Radial transaxial fiducial lines were created relative to the implant site. Standard deviations of the gray density values (image noise) were calculated at fixed distances on the fiducial lines on the buccal and lingual aspects at specific axial levels, and mean values for FBP and IR were compared using paired t-tests. Significance was defined as p < 0.05., Results: The overall mean for image noise (± SD) for FBP was 198.65 ± 55.58 and 99.84 ± 16.28 for IR. IR significantly decreased image noise compared to FBP at all acquisition parameters ( p < 0.05). Noise reduction among different scanning protocols ranged between 29.7% (5 × 5 cm FOV) and 58.1% (5mA). IR increased processing time by an average of 35.1 s., Conclusions: IR significantly reduces CBCT image noise compared to standard FBP without substantially increasing processing time.

Background: Optimization of dental cone beam computed tomography (CBCT) imaging is still in a preliminary stage and should be addressed using task-based methods. Dedicated models containing relevant clinical tasks for image quality studies have yet to be developed., Purpose: To present a methodology to develop and validate a virtual adult anthropomorphic voxel phantom for use in task-based image quality optimization studies in dental CBCT imaging research, focusing on root fracture (RF) detection tasks in the presence of metal artefacts., Methods: The phantom was developed from a CBCT scan with an isotropic voxel size of 0.2 mm, from which the main dental structures, mandible and maxilla were segmented. The missing large anatomical structures, including the spine, skull and remaining soft tissues, were segmented from a lower resolution full skull scan. Anatomical abnormalities were absent in the areas of interest. Fine detailed dental structures, that could not be segmented due to the limited resolution and noise in the clinical data, were modelled using a-priori anatomical knowledge. Model resolution of the teeth was therefore increased to 0.05 mm. Models of RFs as well as dental restorations to create the artefacts, were developed, and could be inserted in the phantom in any desired configuration. Simulated CBCT images of the models were generated using a newly developed multi-resolution simulation framework that incorporated the geometry, beam quality, noise and spatial resolution characteristics of a real dental CBCT scanner. Ray-tracing and Monte Carlo techniques were used to create the projection images, which were reconstructed using the classical FDK algorithm. Validation of the models was assessed by measurements of different tooth lengths, the pulp volume and the mandible, and comparison with reference values. Additionally, the simulated images were used in a reader study in which two oral radiologists had to score the realism level of the model's normal anatomy, as well as the modelled RFs and restorations., Results: A model of an adult head, as well as models of RFs and different types of dental restorations were created. Anatomical measurements were consistent with ranges reported in literature. For the tooth length measurements, the deviations from the mean reference values were less than 20%. In 77% of all the measurements, the deviations were within 10.1%. The pulp volumes, and mandible measurements were within one standard deviation of the reference values. Regarding the normal anatomy, both readers considered the realism level of the dental structures to be good. Background structures received a lower realism score due to the lack of detailed enough trabecular bone structure, which was expected but not the focus of this study. All modelled RFs were scored at least adequate by at least one of the readers, both in appearance and position. The realism level of the modelled restorations was considered to be good., Conclusions: A methodology was proposed to develop and validate an anthropomorphic voxel phantom for image quality optimization studies in dental CBCT imaging, with a main focus on RF detection tasks. The methodology can be extended further to create more models representative of the clinical population., (© 2023 The Authors. Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.)

Objective: We investigated relationships between the triarchic model of psychopathy, coping styles, and externalizing and internalizing symptoms, and verified the mediating effect of coping styles., Methods: Participants were 957 adults responding to the Triarchic Psychopathy Measure, Inventory of depression and anxiety symptoms expanded version, and Crime and Analogous Behavior Scale., Results: Data were analyzed using four path analyses to test our hypothesis, indicating each triarchic trait is differently associated with psychological symptoms and coping styles. We also observed the preference for some coping styles affecting the association between triarchic traits and psychological symptoms., Conclusion: Our findings suggest that coping styles affect only the associations between boldness*distress and boldness*fear, indicating that specific coping strategies can account for variations in distress and fear linked to boldness., Competing Interests: No conflicts of interest declared concerning the publication of this article.

Introduction: Tibial shaft fracture is the most common long-bone fracture, and the standard treatment is intramedullary (IM) nail fixation. Regardless of the development of this technique pseudoarthrosis remains prevalent., Objectives: Evaluate the correlation between wedge fragment size and displacement, displacement of the main fragments of the 42B2 type, and pseudoarthrosis incidence., Methods: We retrospectively assessed all patients with 42B2 type fracture treated with IM nailing between January, 2015 and December, 2019. Six radiographic parameters were defined for preoperative radiographs in the anteroposterior (AP) and lateral views. Another six parameters were defined for postoperative radiographs at three, six, and 12 months. The Radiographic Union Score for Tibial Fractures score was used to assess bone healing., Results: Of 355 patients with tibial shaft fractures, 51 were included in the study. There were 41 (82.0%) male patients, with a mean age of 36.7 years, 37 (72.5%) had open fractures, and 28 (54.9%) had associated injuries. After statistical analysis, the factors that correlated significantly with nonunion were wedge height > 18 mm, preoperative translational displacement of the fracture in the AP view > 18 mm, and final distance of the wedge in relation to its original anatomical position after IM nailing > 5 mm., Conclusion: Risk factors for nonunion related to the wedge and42B2 fracture are wedge height > 18 mm, initial translation in the AP view of the fracture > 18 mm, and distance > 5 mm of the wedge from its anatomical position after IM nailing. Evidence level III; Retrospective comparative study ., Competing Interests: All authors declare no potential conflict of interest related to this article.

Bladder cancer is the fourth most common malignancy in men. It can present along the entire continuum of severity, from mild to well-differentiated disease to extremely malignant tumors with low survival rates. Human RAS genes are the most frequently mutated oncogenes in human cancers, and the critical role of aberrant Ras protein function in carcinogenesis is well established. Therefore, considerable efforts have been devoted to the development of anti-Ras inhibitors for cancer treatment. This study presents the biphenyl dihydropyrimidinone LaSOM 335 with high activity against T24 bladder cancer cells (IC 50  = 10.73 ± 0.53 μM) and selectivity of cytotoxicity for this cancer cell line compared to two non-cancer cell lines investigated. Furthermore, we also show that this compound reduced vulvar development in the mutant let-60 gene of Caenorhabditis elegans. Let-60 is a homolog of the mammalian Ras gene. In addition, we observed that LaSOM 335 inhibits the enzymatic activity of CD73 and decreases CD73 expression. Possibly, this expression decrease is due to downstream EGFR signaling via the Ras-Raf-ERK pathway, that directly regulates CD73 expression via ERK1/2. Evidence suggests that non-immunomodulating functions of CD73 play an equally important role for cancer cell survival, progression, and migration. Regarding we also notice that LaSOM 335 was safe in the in vivo model of C. elegans. The set of these findings makes this biphenyl dihydropyrimidinone a promising candidate for further investigations in the bladder cancer field., (© 2023 John Wiley & Sons Ltd.)

Amyotrophic Lateral Sclerosis is a disease that compromises the motor system and the functional abilities of the person in an irreversible way, causing the progressive loss of the ability to communicate. Tools based on Augmentative and Alternative Communication are essential for promoting autonomy and improving communication, life quality, and survival. This Systematic Literature Review aimed to provide evidence on eye-image-based Human-Computer Interaction approaches for the Augmentative and Alternative Communication of people with Amyotrophic Lateral Sclerosis. The Systematic Literature Review was conducted and guided following a protocol consisting of search questions, inclusion and exclusion criteria, and quality assessment, to select primary studies published between 2010 and 2021 in six repositories: Science Direct, Web of Science, Springer, IEEE Xplore, ACM Digital Library, and PubMed. After the screening, 25 primary studies were evaluated. These studies showcased four low-cost, non-invasive Human-Computer Interaction strategies employed for Augmentative and Alternative Communication in people with Amyotrophic Lateral Sclerosis. The strategies included Eye-Gaze, which featured in 36% of the studies; Eye-Blink and Eye-Tracking, each accounting for 28% of the approaches; and the Hybrid strategy, employed in 8% of the studies. For these approaches, several computational techniques were identified. For a better understanding, a workflow containing the development phases and the respective methods used by each strategy was generated. The results indicate the possibility and feasibility of developing Human-Computer Interaction resources based on eye images for Augmentative and Alternative Communication in a control group. The absence of experimental testing in people with Amyotrophic Lateral Sclerosis reiterates the challenges related to the scalability, efficiency, and usability of these technologies for people with the disease. Although challenges still exist, the findings represent important advances in the fields of health sciences and technology, promoting a promising future with possibilities for better life quality.

Osteoporosis is a disease characterized by impairment of bone microarchitecture that causes high socioeconomic impacts in the world because of fractures and hospitalizations. Although dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing the disease, access to DXA in developing countries is still limited due to its high cost, being present only in specialized hospitals. In this paper, we analyze the performance of Osseus, a low-cost portable device based on electromagnetic waves that measures the attenuation of the signal that crosses the medial phalanx of a patient's middle finger and was developed for osteoporosis screening. The analysis is carried out by predicting changes in bone mineral density using Osseus measurements and additional common risk factors used as input features to a set of supervised classification models, while the results from DXA are taken as target (real) values during the training of the machine learning algorithms. The dataset consisted of 505 patients who underwent osteoporosis screening with both devices (DXA and Osseus), of whom 21.8% were healthy and 78.2% had low bone mineral density or osteoporosis. A cross-validation with k-fold = 5 was considered in model training, while 20% of the whole dataset was used for testing. The obtained performance of the best model (Random Forest) presented a sensitivity of 0.853, a specificity of 0.879, and an F1 of 0.859. Since the Random Forest (RF) algorithm allows some interpretability of its results (through the impurity check), we were able to identify the most important variables in the classification of osteoporosis. The results showed that the most important variables were age, body mass index, and the signal attenuation provided by Osseus. The RF model, when used together with Osseus measurements, is effective in screening patients and facilitates the early diagnosis of osteoporosis. The main advantages of such early screening are the reduction of costs associated with exams, surgeries, treatments, and hospitalizations, as well as improved quality of life for patients., (© 2023. Springer Nature Limited.)

Objective:  To present the update of the recommendations of the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Society of Mastology and the Brazilian Federation of Associations of Gynecology and Obstetrics for breast cancer screening in Brazil., Methods:  Scientific evidence published in Medline, EMBASE, Cochrane Library, EBSCO, CINAHL and Lilacs databases between January 2012 and July 2022 was searched. Recommendations were based on this evidence by consensus of the expert committee of the three entities., Recommendations:  Annual mammography screening is recommended for women at usual risk aged 40-74 years. Above 75 years, it should be reserved for those with a life expectancy greater than seven years. Women at higher than usual risk, including those with dense breasts, with a personal history of atypical lobular hyperplasia, classic lobular carcinoma in situ, atypical ductal hyperplasia, treatment for breast cancer or chest irradiation before age 30, or even, carriers of a genetic mutation or with a strong family history, benefit from complementary screening, and should be considered individually. Tomosynthesis is a form of mammography and should be considered in screening whenever accessible and available., Competing Interests: None to declare., (Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Objective: To present an update of the recommendations of the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Society of Mastology, and the Brazilian Federation of Gynecology and Obstetrics Associations for breast cancer screening in Brazil., Materials and Methods: Scientific evidence published between January 2012 and July 2022 was gathered from the following databases: Medline (PubMed); Excerpta Medica (Embase); Cochrane Library; Ebsco; Cumulative Index to Nursing and Allied Health Literature (Cinahl); and Latin-American and Caribbean Health Sciences Literature (Lilacs). Recommendations were based on that evidence and were arrived at by consensus of a joint committee of experts from the three entities.Recommendations: Annual mammographic screening is recommended for women between 40 and 74 years of age. For women at or above the age of 75, screening should be reserved for those with a life expectancy greater than seven years. Women at higher than average risk are considered by category: those with dense breasts; those with a personal history of atypical lobular hyperplasia, classical lobular carcinoma in situ, or atypical ductal hyperplasia; those previously treated for breast cancer; those having undergone thoracic radiotherapy before age 30; and those with a relevant genetic mutation or a strong family history. The benefits of complementary screening are also addressed according to the subcategories above. The use of tomosynthesis, which is an evolved form of mammography, should be considered in screening, whenever accessible and available.

Purpose: The purposes of the study were to: i) verify the variations in training load and the subsequent effects on swimming performance parameters, biochemical parameters, and autonomic nervous activity during a water polo season; ii) investigate the sensitivity of physiological markers in tracking training load and performance variations, and iii) verify the overreaching prevalence. Method: The training load of 20 female water polo players was monitored (using the session rating of perceived exertion method [sRPE], training monotony, and strain), and the lactate minimum speed (LMS), repeated sprint ability (RSA), plasma hormone and glutamine concentration, salivary immunoglobulin A (SIgA), and heart rate variability (lnRMSSD) were evaluated during the season. Result: The training load parameters were higher in the competitive cycle ( p ≤ 0.002). The LMS improved only in the general cycle from baseline ( p = .015), while the RSA best time improved in the general ( p = .002) and specific cycles ( p = .012) from baseline and deteriorated in the competitive from general cycle ( p = .008). The SIgA secretion rate presented a reduction only in the specific cycle from baseline ( p = .032), while the lnRMSSD increased in the general ( p = .038) and competitive ( p < .001) cycles from baseline. Five athletes were diagnosed as overreaching state. Conclusion: Therefore, the physiological markers (i.e., plasma hormone and glutamine concentration, SIgA, and lnRMSSD) showed little sensitivity to detect changes in training load and swimming performance. The higher training loads applied in the competitive cycle seem to limit swimming performance gains.

Objectives: The aim of this study was to evaluate the influence of peak kilovoltage (kVp) and a metal artifact reduction (MAR) tool on image quality and the diagnosis of vertical root fracture (VRF) in cone-beam computed tomography (CBCT)., Materials and Methods: Twenty single-rooted human teeth filled with an intracanal metal post were divided into 2 groups: control ( n = 10) and VRF ( n = 10). Each tooth was placed into the socket of a dry mandible, and CBCT scans were acquired using a Picasso Trio varying the kVp (70, 80, 90, or 99), and the use of MAR (with or without). The examinations were assessed by 5 examiners for the diagnosis of VRF using a 5-point scale. A subjective evaluation of the expression of artifacts was done by comparing random axial images of the studied protocols. The results of the diagnoses were analyzed using 2-way analysis of variance and the Tukey post hoc test, the subjective evaluations were compared using the Friedman test, and intra-examiner reproducibility was evaluated using the weighted kappa test (α = 5%)., Results: The kVp and MAR did not influence the diagnosis of VRF ( p > 0.05). According to the subjective classification, the 99 kVp protocol with MAR demonstrated the least expression of artifacts, while the 70 kVp protocol without MAR led to the most artifacts., Conclusions: Protocols with higher kVp combined with MAR improved the image quality of CBCT examinations. However, those factors did not lead to an improvement in the diagnosis of VRF., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported., (Copyright © 2023. The Korean Academy of Conservative Dentistry.)

Background: Men who have sex with men (MSM) and transgender women (TGW) are disproportionately affected by HIV, with much higher incidence and prevalence rates than in the general population in different countries. There are several barriers to testing among MSM and TGW, such as low risk perception, anticipation of HIV-related stigma, discrimination of sexual orientation, in addition to difficulties related to care and access to health services. Therefore, analyzing the available evidence of the effectiveness of strategies for scaling up HIV testing among key populations is essential to point out potential knowledge gaps which may need to be addressed and develop public health policies to promote testing and early diagnosis of HIV infection., Methods: An integrative review was carried out to evaluate strategies for scaling up HIV testing in these populations. Search strategy was performed on eight electronic databases, without language restriction. We included clinical trials, quasi-experimental studies, and non-randomized studies. Study selection and data extraction were both performed independently by pairs and disagreements were solved by a third revisor. The screening of the studies was carried out through the selection of titles/abstracts and the reading of the full texts of the pre-selected studies based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Data extraction was performed using a structured form., Results: Thirty-seven publications referring to 35 studies were included, mostly being carried out in the United States of America and Australia. No studies were found evaluating disaggregated data on TGW. The studies were grouped into four types of intervention strategies: self-test distribution system (n = 10), organization of health services (n = 9), peer education (n = 6), and social marketing campaign (n = 10). Strategies that focused on the first three groups, combined or not, were more effective in increasing HIV testing among MSM., Conclusions: Considering the diversity of interventions and the methodological heterogeneity of the included studies, strategies especially involving self-test distribution systems, associated with new information and communication technologies, should be evaluated in different communities and social contexts. Research evaluating specific studies on TGW population is still needed., (© 2023. The Author(s).)

Personality traits play a role in prosocial behavior in relation to containment measures intended to tackle the COVID-19 pandemic. Empirical findings indicated that individuals high in socially aversive traits such as callousness are less compliant with containment measures. This study aimed to add cross-cultural data on the relationship between antisocial traits and adherence to COVID-19 containment measures. The sample consisted of 4,538 adults recruited by convenience in nine countries (Australia, Brazil, England, Iraq, Iran, Italy, Jordan, Saudi Arabia, and the United States). Statistical analyses indicated two latent profiles from our sample, empathic and antisocial, and six COVID-19 containment-measure-related factors using measures covering antisocial traits (PID-5), empathy (ACME), global personality pathology (LPFS-BF), and COVID-19 behaviors and beliefs. Through MANCOVA, the antisocial profile consistently showed less compliance and concern about the COVID-19 containment measures, even when controlling for demographics and local pandemic covariables. The network analysis indicated a lack of empathy and callousness as crucial traits of the predisposition to non-compliant behavior. In elaborating on prosocial campaigns in community emergencies, our cross-cultural findings would need to consider personality traits that focus on antisociality, anticipating similar associations and potential impacts in future disease outbreaks., (© 2022 Scandinavian Psychological Associations and John Wiley & Sons Ltd.)

Objective: To assess the outcome of extubation in COVID-19 patients and the use of noninvasive ventilation in the weaning process., Methods: This retrospective, observational, single-center study was conducted in COVID-19 patients aged 18 years or older who were admitted to an intensive care unit between April 2020 and December 2021, placed under mechanical ventilation for more than 48 hours and progressed to weaning. Early extubation was defined as extubation without a spontaneous breathing trial and immediate use of noninvasive ventilation after extubation. In patients who underwent a spontaneous breathing trial, noninvasive ventilation could be used as prophylactic ventilatory assistance when started immediately after extubation (prophylactic noninvasive ventilation) or as rescue therapy in cases of postextubation respiratory failure (therapeutic noninvasive ventilation). The primary outcome was extubation failure during the intensive care unit stay., Results: Three hundred eighty-four extubated patients were included. Extubation failure was observed in 107 (27.9%) patients. Forty-seven (12.2%) patients received prophylactic noninvasive ventilation. In 26 (6.8%) patients, early extubation was performed with immediate use of noninvasive ventilation. Noninvasive ventilation for the management of postextubation respiratory failure was administered to 64 (16.7%) patients., Conclusion: We found that COVID-19 patients had a high rate of extubation failure. Despite the high risk of extubation failure, we observed low use of prophylactic noninvasive ventilation in these patients.

Background: Atrial fibrillation (AF) affects about 2% to 4% of the world population, and in patients hospitalized in intensive care units, this incidence can reach up to 23% in those with septic shock. The impact of AF in patients with sepsis is reflected in worse clinical outcomes, and the identification of the triggering factors can be a target for future prevention and treatment strategies., Objectives: To verify the relationship between the development of AF and mortality in patients over 80 years of age included in the sepsis protocol and to identify the risk factors that contribute to the development of AF in this population., Methods: Retrospective observational study, with a review of electronic medical records and inclusion of 895 patients aged 80 years or older, included in the sepsis protocol of a high-complexity private hospital in São Paulo, SP, from January 2018 to December 2020. All tests were performed with a significance level of 5%., Results: The incidence of AF in the sample was 13%. After multivariate analysis, using multiple logistic regression, it was possible to demonstrate an association of mortality, in the studied population, with the SOFA score (odds ratio [OR] 1.21 [1.09 - 1.35]), higher values of C-reactive protein (OR 1.04 [1.01 - 1.06]), need for vasoactive drugs (OR 2.4 [1.38 - 4.18]), use of mechanical ventilation (OR 3.49 [1.82 - 6.71]), and mainly AF (OR 3.7 [2.16 - 6.31])., Conclusion: In very elderly patients (80 years of age and older) with sepsis, the development of AF was shown to be an independent risk factor for in-hospital mortality.

The purinergic signaling has drawn attention from academia and more recently from pharmaceutical industries as a potential therapeutic route for cancer treatment, since ATP may act as chemotactic agent and possess in vitro antineoplastic activity. On the other way, adenosine, produced in extracellular medium by ecto-5'-NT, acts as immunosuppressor and is related to neoangiogenesis, vasculogenesis and evasion to the immune system. Consequently, inhibitors of ecto-5'-NT may prevent tumor progression, reducing adenosine concentrations, preventing escape from the host's immune system and slowing cancer's growth. This review aims to highlight important biochemical and structural features of ecto-5'NT, highlight its expression profile in normal and cancer cell lines detailing compounds which may act as expression regulators and to review the several classes of ecto-5'NT inhibitors developed in the past 12 years, in order to build a general structure-activity relationship model to guide further compound design., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Shrimp antilipopolysaccharide factors (ALFs) form a multifunctional and diverse family of antimicrobial host defense peptides (AMPs) composed of seven members (groups A to G), which differ in terms of their primary structure and biochemical properties. They are amphipathic peptides with two conserved cysteine residues stabilizing a central β-hairpin that is understood to be the core region for their biological activities. In this study, we synthetized three linear (cysteine-free) peptides based on the amino acid sequence of the central β-hairpin of the newly identified shrimp ( Litopenaeus vannamei ) ALFs from groups E to G. Unlike whole mature ALFs, the ALF-derived peptides exhibited an α-helix secondary structure. In vitro assays revealed that the synthetic peptides display a broad spectrum of activity against both Gram-positive and Gram-negative bacteria and fungi but not against the protozoan parasites Trypanosoma cruzi and Leishmania ( L .) infantum . Remarkably, they displayed synergistic effects and showed the ability to permeabilize bacterial membranes, a mechanism of action of classical AMPs. Having shown low cytotoxicity to THP-1 human cells and being active against clinical multiresistant bacterial isolates, these nature-inspired peptides represent an interesting class of bioactive molecules with biotechnological potential for the development of novel therapeutics in medical sciences.

Introduction: The Acute Leukemia-European Society for Blood and Marrow Transplantation (AL-EBMT) risk score was recently developed and validated by Shouval et al. OBJECTIVE: To assess the ability of this score in predicting the 2-year overall survival (OS-2), leukemia-free survival (LFS-2) and transplant-related mortality (TRM) in acute leukemia (AL) adult patients undergoing a first allogeneic hematopoietic stem cell transplant (HSCT) at a transplant center in Brazil., Methods: In this prospective, cohort study, we used the formula published by Shouval et al. to calculate the AL-EBMT score and stratify patients into three risk categories., Results: A total of 79 patients transplanted between 2008 and 2018 were analyzed. The median age was 38 years. Acute myeloid leukemia was the most common diagnosis (68%). Almost a quarter of the cases were at an advanced stage. All hematopoietic stem cell transplantations (HSCTs) were human leukocyte antigen-matched (HLA-matched) and the majority used familial donors (77%). Myeloablative conditioning was used in 92% of the cases. Stratification according to the AL-EBMT score into low-, intermediate- and high-risk groups yielded the following results: 40%, 12% and 47% of the cases, respectively. The high scoring group was associated with a hazard ratio of 2.1 (p = 0.007), 2.1 (p = 0.009) and 2.47 (p = 0.01) for the 2-year OS, LFS and TRM, respectively., Conclusion: This study supports the ability of the AL-EBMT score to reasonably predict the 2-year post-transplant OS, LFS and TRM and to discriminate between risk categories in adult patients with AL, thus confirming its usefulness in clinical decision-making in this setting. Larger, multicenter studies may further help confirm these findings., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2021 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)

Hydroxychloroquine sulfate (HCQ) and chloroquine diphosphate (CQ) have been used at increased rates to treat COVID-19 but can constitute a potential environmental risk. The objective was to evaluate the toxicity of sublethal concentrations of HCQ and CQ in zebrafish embryos/larvae. The 50% lethal concentrations (LC 50 ) of HCQ and CQ at 96 h post-fertilization (hpf) were calculated by testing various concentrations on 2,160 embryos. The LC 50 obtained were 560 and 800 µM for HCQ and CQ, respectively. Next, the embryotoxicity assay was performed, where 1,200 embryos were subjected to sublethal concentrations of HCQ and CQ. The hatching and heart rates were recorded. After euthanasia, photomicrographs of all larvae were taken to measure the total length, pericardial and yolk sac areas. The embryos exposed to sublethal concentrations of HCQ and CQ showed delayed hatching at 72 hpf, as well as an increase in the heart rate, larger pericardial and yolk sac areas, and body malformations at 96 hpf. The findings show that HCQ and CQ are toxic to fish in the early development phases. Understanding the mechanisms of toxicity will help extrapolate the effects of 4-aminoquinoline derivatives when they reach the aquatic environment in the context of the COVID-19 pandemic.

Background: Dimeric acylphloroglucinols occurring in species from sections Brathys and Trigynobrathys of the genus Hypericum exhibit acylfilicinic acid and acylphloroglucinol moieties linked by a methylene bridge. However, this chemical feature differs from hyperforin, from H. perforatum (Hypericum section). Some dimeric acylphloroglucinols, such as uliginosin B, display similar pharmacological activities, namely antidepressant and antinociceptive. However, there is no knowledge about the pharmacokinetic profile and no toxicity studies of these compounds in intact mammals., Objective: To perform an in silico evaluation of the similarity, pharmacokinetics and toxicity (ADMET) properties of dimeric acylphloroglucinols from species native to Central and South America., Methods: ADMET prediction of eleven elected phloroglucinols followed by the chemical space evaluation of thirty-five dimeric acylphloroglucinols derivatives labeled according to their prenylation/ geranylation pattern through principal component analysis (PCA). The similarity analysis was performed using the Tanimoto similarity index. ADMET properties were predicted with the opensource software SwissADME and pkCSM-pharmacokinetics., Results: Several compounds showed good human intestinal absorption. However, they may present difficulties in crossing the blood-brain barrier, probably due to the high tPSA values. The predicted toxicity parameters indicated that most compounds have low toxicity. Most non-prenylated phloroglucinols were disposed into Lipinski's rule limits. Uliginosin B, isouliginosin B and japonicin A seem to be druglike compounds. The PCA model explained 77.49% of the total variance, and molecular similarity analyses revealed some expected similarities between isomers and different compounds., Conclusion: Dimeric acylphloroglucinols may be promising drug candidates and deserve further pharmacological and medicinal chemistry studies., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Advanced glycation end products (AGEs) are compounds formed after the non-enzymatic addition of reducing sugars to lipids, proteins, and nucleic acids. They are associated with the development of various clinical complications observed in diabetes and cardiovascular diseases, such as retinopathy, nephropathy, diabetic neuropathy, and others. In addition, compelling evidence indicates that these molecules participate in the progression of neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. Multiple cellular and molecular alterations triggered by AGEs that could alter homeostasis have been identified. One of the main targets for AGE signaling is the receptor for advanced glycation end-products (RAGE). Importantly, this receptor is the target of not only AGEs, but also amyloid β peptides, HMGB1 (high-mobility group box-1), members of the S100 protein family, and glycosaminoglycans. The activation of this receptor induces intracellular signaling cascades that are involved in pathological processes and cell death. Therefore, RAGE represents a key target for pharmacological interventions in neurodegenerative diseases. This review will discuss the various effects of AGEs and RAGE activation in the pathophysiology of neurodegenerative diseases, as well as the currently available pharmacological tools and promising drug candidates., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Most patients who undergo tetralogy of Fallot (TOF) repair experience late right ventricle (RV) dysfunction due to pulmonary valve regurgitation (PVR). Cardiac magnetic resonance (CMR) is the gold standard method for evaluating RV during follow-up. Global longitudinal strain (GLS) has been introduced as a novel method for the assessment of RV dysfunction. We aimed to compare the feasibility of GLS and CMR for assessing RV function after TOF repair., Methods: We systematically reviewed the English literature using PubMed, SciELO and Google Scholar for articles published between January 1, 2015, and December 31, 2020. Articles evaluating RV function comparing by GLS and CMR after TOF repair were included., Results: Nine studies including 465 patients were analyzed. Most patients were men (280; 60%), the male:female ratio was 1.5:1, and the age range was .8 to 57.7 years. The mean follow-up time was 6 to 32 months. The correlation between RV GLS and RV ejection fraction (EF) by CMR was negative for the articles and varied from moderate to strong (r = -.45, r = -.60, r = -.76)., Conclusion: Right ventricle GLS can be considered for routine follow-up of TOF repair patients, even though CMR remains the noninvasive gold standard method. Using a single parameter may not allow comparison of the accuracy of 3D RV EF by using CMR and GLS. Further studies with a larger number of patients undergoing TOF repair are required to evaluate the correlation between these examinations., (© 2022 Wiley Periodicals LLC.)

Background: Although a great number of teleconsultation services have been developed during the COVID-19 pandemic, studies assessing usability and health care provider satisfaction are still incipient., Objective: This study aimed to describe the development, implementation, and expansion of a synchronous teleconsultation service targeting patients with symptoms of COVID-19 in Brazil, as well as to assess its usability and health care professionals' satisfaction., Methods: This mixed methods study was developed in 5 phases: (1) the identification of components, technical and functional requirements, and system architecture; (2) system and user interface development and validation; (3) pilot-testing in the city of Divinópolis; (4) expansion in the cities of Divinópolis, Teófilo Otoni, and Belo Horizonte for Universidade Federal de Minas Gerais faculty and students; and (5) usability and satisfaction assessment, using Likert-scale and open-ended questions., Results: During pilot development, problems contacting users were solved by introducing standardized SMS text messages, which were sent to users to obtain their feedback and keep track of them. Until April 2022, the expanded system served 31,966 patients in 146,158 teleconsultations. Teleconsultations were initiated through chatbot in 27.7% (40,486/146,158) of cases. Teleconsultation efficiency per city was 93.7% (13,317/14,212) in Teófilo Otoni, 92.4% (11,747/12,713) in Divinópolis, and 98.8% (4981/5041) in Belo Horizonte (university campus), thus avoiding in-person assistance for a great majority of patients. In total, 50 (83%) out of 60 health care professionals assessed the system's usability as satisfactory, despite a few system instability problems., Conclusions: The system provided updated information about COVID-19 and enabled remote care for thousands of patients, which evidenced the critical role of telemedicine in expanding emergency services capacity during the pandemic. The dynamic nature of the current pandemic required fast planning, implementation, development, and updates in the system. Usability and satisfaction assessment was key to identifying areas for improvement. The experience reported here is expected to inform telemedicine strategies to be implemented in a postpandemic scenario., (©Milena Soriano Marcolino, Clara Sousa Diniz, Bruno Azevedo Chagas, Mayara Santos Mendes, Raquel Prates, Adriana Pagano, Thiago Castro Ferreira, Maria Beatriz Moreira Alkmim, Clara Rodrigues Alves Oliveira, Isabela Nascimento Borges, Magda César Raposo, Zilma Silveira Nogueira Reis, Maria Cristina Paixão, Leonardo Bonisson Ribeiro, Gustavo Machado Rocha, Clareci Silva Cardoso, Antonio Luiz Pinho Ribeiro. Originally published in JMIR Medical Informatics (https://medinform.jmir.org), 22.12.2022.)

Background: Black fungi of the Herpotrichiellaceae family are agents of chromoblastomycosis and phaeohyphomycosis. There are few therapeutic options for these infections and it is common to associate antifungal drugs in their treatment., Objectives: To investigate the Medicines for Malaria Venture (MMV) Pathogen Box® for possible compounds presenting synergism with antifungal drugs used to treat black fungal infections., Methods: An initial screening of the Pathogen Box® compounds was performed in combination with itraconazole or terbinafine at sub-inhibitory concentrations against Fonsecaea pedrosoi. Hits were further tested against eight Herpotrichiellaceae using the checkerboard method., Findings: No synergism was observed with terbinafine. MMV687273 (SQ109) and MMV688415 showed synergism with itraconazole against F. pedrosoi. Synergism of these compounds was confirmed with some black fungi by the checkerboard method. SQ109 and itraconazole presented synergism for Exophiala dermatitidis, F. pedrosoi, F. monophora and F. nubica, with fungicidal activity for F. pedrosoi and F. monophora. MMV688415 presented synergism with itraconazole only for F. pedrosoi, with fungicidal activity. The synergic compounds had high selectivity index values when combined with itraconazole., Main Conclusions: These compounds in combination, particularly SQ109, are promising candidates to treat Fonsecaea spp. and E. dermatitidis infections, which account for most cases of chromoblastomycosis and phaeohyphomycosis.

The authors investigated the latent structure of schizotypal personality features using taxometric analysis in a large sample of individuals from clinical and nonclinical populations. A total of 7,072 community adults and 270 psychiatric patients participated in the study by responding to the eccentricity, distrust, and isolation scales from the Dimensional Clinical Personality Inventory (IDCP). Data were analyzed using three different taxometric techniques, MAMBAC, MAXEIG, and L-Mode. The indicators proved valid for the taxometric analysis (d ≥ 1.25). The comparison curve fit index (CCFI) coefficients from the three methods used were close to zero, and the average CCFI was lower than .40, clearly indicating a dimensional structure for schizotypal personality features. These findings suggest that schizotypal personality traits occur in levels, with no evidence of any natural boundary between clinical and nonclinical manifestations. Results from other studies that were consistent with a categorical structure may be due to methodological weaknesses.

Objective: To identify and synthesize scientific evidence that the use of face protection masks by children, in the community and at home, is a way of preventing communicable diseases., Data Source: A scoping review was made using the Joana Briggs Institute method and PRISMA-ScR. A research was carried out in five electronic databases, at the Cochrane Library and on seven websites of governmental and non-governmental institutions. The data were organized in a spreadsheet and submitted to narrative analysis., Data Synthesis: Initially, 658 productions were identified, of which 19 made up the final sample. Studies with higher levels of evidence are scarce. The types of masks identified were professional (surgical and facial respirators with filtration) and non-professional (homemade). The transmissible agents studied were influenza and SARS-CoV-2 viruses, and the evaluated environments were schools, homes and community spaces. The main discomforts reported were heat, shortness of breath, headache and maladjustment to the face. The indication and acceptability of masks change according to the age group and clinical conditions. There is no consensus on the reduction in the transmissibility of infections., Conclusions: Children older than five can benefit from the correct use of masks, as long as they are supervised, taught and educated to do so and the masks should be well adjusted to the face. The use of masks show better results when associated with other measures such as physical distancing, keeping places ventilated and frequent hand hygiene.

Objectives: This manuscript provides novel insights about the potential use of social media (a Facebook page, the first strategic attempt by EviDent initiative) to share evidence-based dentistry content and empowerment strategies for professionals, using quantifiable usage metrics, besides exposing the strengths and weaknesses of this knowledge translation strategy. One year-long gathered metrics were analyzed to understand information about usage patterns., Results: Publications were potentially exposed to 4784 users, and subsequent interaction with the page occurred in 18% of cases. Users' involvement with page content was associated with the number of page visitors (P = .005). However, users' interaction with the page was not associated with the potential number of users that could have seen the page (P = .25). Even considering the users that approved the posts, only 7%, on average, interacted with the post's links. Although social media has effectively disseminated scientific content, our experience revealed the user's passivity in interacting with the content. We expect to overcome these barriers by developing a mobile app to offer a more interactive and dynamic interface associated with a more attractive format for posting, including images and infographics., (© 2022. The Author(s).)

The objective of this retrospective longitudinal study was to evaluate the relationship between dry period length and the production of milk, fat, protein, lactose and total milk solids in the subsequent lactation of Holstein dairy cows under tropical climate. After handling and cleaning of the data provided by the Holstein Cattle Breeders Association of Minas Gerais, data from 32 867 complete lactations of 19 535 Holstein animals that calved between 1993 and 2017 in 122 dairy herds located in Minas Gerais state (Brazil) were analysed. In addition to dry period length, calving age, lactation length, milking frequency, parity, calf status at birth, herd, year, and season of calving were included in the analysis as covariables to account for additional sources of variation. The machine learning algorithms gradient boosting machine, extreme gradient boosting machine, random forest and artificial neural network were used to train models using cross validation. The best model was selected based on four error metrics and used to evaluate the variable importance, the interaction strength between dry period length and the other variables, and to generate partial dependency plots. Random forest was the best model for all production outcomes evaluated. Dry period length was the third most important variable in predicting milk production and its components. No strong interactions were observed between the dry period and the other evaluated variables. The highest milk and lactose productions were observed with a 50-d long dry period, while fat, protein, and total milk solids were the highest with dry period lengths of 38, 38, and 44 d, respectively. Overall, dry period length is associated with the production of milk and its components in the subsequent lactation of Holstein cows under tropical climatic conditions, but the optimum length depends on the production outcome.

This study investigated the associations of multidimensional perfectionism with positive affect and negative outcomes (affect and Obsessive-Compulsive Personality Disorder [OCPD] pathological traits) through network analysis. The sample consisted of 604 Brazilian adults aged 18-74 years. The network analysis showed that perfectionistic concerns (PC) is strongly and positively associated with negative outcomes, while perfectionistic strivings (PS) maintain positive associations with positive affect, but not negative affect. Negative affect seems to operate as a bridge between perfectionism and OCPD pathological traits, raising crucial questions about the antecedent and consequential role of affect for understanding perfectionism's development and the traits observed in individuals with OCPD. We discuss the limitations and strengths of the study., (© 2022 Scandinavian Psychological Associations and John Wiley & Sons Ltd.)