Search

Objective: To evaluate the ability of certified retinal imagers to identify presence versus absence of sight-threatening diabetic retinopathy (stDR) (moderate nonproliferative diabetic retinopathy or worse or diabetic macular edema) at the time of retinal imaging in a telemedicine program.Research Design and Methods: Diabetic patients in a primary care setting or specialty diabetes clinic received Joslin Vision Network protocol retinal imaging as part of their care. Trained nonphysician imagers graded the presence versus absence of stDR at the time of imaging. These gradings were compared with masked gradings of certified readers.Results: Of 158 patients (316 eyes) imaged, all cases of stDR (42 eyes [13%]) were identified by the imagers at the time of imaging. Six eyes with mild nonproliferative diabetic retinopathy were graded by the imagers to have stDR (sensitivity 1.00, 95% CI 0.90-1.00; specificity 0.97, 0.94-0.99).Conclusions: Appropriately trained imagers can accurately identify stDR at the time of imaging. [ABSTRACT FROM AUTHOR]

Bacillus subtilis is known to promote root growth and improve plant physiology, while organic compost enhances soil water retention. This study explored the combined effect of inoculating B. subtilis in organic compost on soybean growth under water deficit. The treatments included chemical fertilization, non-inoculated organic compost, and organic compost inoculated with B. subtilis which were assessed under well-watered and water-deficit conditions. The organic compost inoculated with B. subtilis increased root biomass, length, volume, and the number of root tips under well-watered conditions, although it reduced root diameter. Under water deficit, the organic compost inoculated with B. subtilis increased root tip number (∼150%), biomass (∼95%) and number (∼85%) of nodules. Water deficit negatively affected soybean physiology, reduced photosynthesis, transpiration, and stomatal conductance, while increased internal CO₂ concentration. However, the organic compost inoculated with B. subtilis mitigated these effects, enhancing photosynthesis (∼20%) and water use efficiency (∼25%). Under water deficit, this treatment also increased shoot biomass by 15% and the drought tolerance index by 51% compared to the control. The combination of B. subtilis and organic compost improved root architecture, nodulation, and drought tolerance. These results suggest that B. subtilis inoculated in the organic compost is a promising strategy for enhancing soybean productivity and resilience under water stress, offering a novel approach to mitigating drought effects in agriculture., 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 © 2025 Elsevier Masson SAS. All rights reserved.)

Ceramic detachments in cladding systems are indicative of adhesion loss between the ceramic tiles and the substrate or its adhesive mortar due to inadequate quality workmanship, the quality of the adhesive mortar or that of the ceramic material, whether acting simultaneously or not. The shear stresses resulting from the ceramic tiles' expansion due to humidity accelerate this process. There is a shortage of studies on the quality of ceramic tiles and adhesive mortars. This study conducted elemental, physical and microstructural characterization tests on ceramic tiles and adhesive mortars that showed detachment up to two years after being laid. At first glance, the adhesive mortar samples had adequate traits and degree of hydration. The ceramic tiles, on the other hand, showed high porosity and high levels of amorphous and poorly sintered materials, with no crystalline phase. In a second analysis, scanning electron microscopy (SEM) tests associated with boiling plus autoclave moisture expansion tests executed on unused ceramic pieces of the same conformation proved to be more suitable for predicting expansion potential than standard tests. Due to the costs and difficulties in accessing and analyzing the SEM tests, chemical analysis of the ceramic tiles was executed using X-ray fluorescence (XRF) to assess the presence of the amorphous silica (free quartz) and alkaline oxides. Together with pressure and temperature determination tests (autoclave), they may represent another alternative that is easier to access and more cost-effective for predicting future expansion.

The objective of this study was to investigate the effect of dynamic pulsation settings that increased the open phase and reduced the closed phase of pulsation during the peak milk flow period together with increasing the milk flow rate switch-point for cluster detachment on milking duration and teat condition after milking. The present study filled current gaps in knowledge by informing on the effects of both milk flow rate switch-points and dynamic pulsation together in one experiment, while presenting data on milking performance, strip milk, teat condition and vacuum levels in the cluster during milking. To this end, 4 treatments consisting of different milk flow rate switch-points and pulsator settings combinations were deployed across 4 groups of 24 cows for 8 weeks. Treatments consisted of 2 levels of milk flow rate switch-point (0.2 kg/min and 0.8 kg/min) and 2 pulsator settings (static and dynamic). The static pulsator settings had a pulsator ratio of 65:35. For the dynamic settings a pulsator ratio of 63:37 below a milk flow rate of 2 kg/min was used, which changed to 73:27 above 2 kg/min. Milking parameters and teat scoring data were analyzed using mixed models. The effect of milk flow rate switch-point on milking duration was significant, whereas the effect of dynamic pulsation was not. The reductions in milking duration were larger for PM milking (for static pulsation settings, the average reduction was 21% between switch-point of 0.2 kg/min and 0.8 kg/min) compared with a 12% reduction for AM milking. In addition, we found a significant effect of treatment on teat-barrel congestion, with reduced odds of teat-barrel ringing for treatments with a milk flow rate switch-point of 0.8 kg/min relative to 0.2 kg/min due to significantly reduced over milking time and hence reduced exposure to higher mouthpiece chamber vacuum during the over milking period. On average across all treatments cows spent 32% of the milking above 2 kg/min, however this varied from 37% for AM milking to 23% on average for PM milking, hence an uneven milking interval impeded the ability of dynamic pulsation to contribute, especially for PM milking. We concluded that milk flow rate switch-point settings are more impactful than dynamic pulsation settings for reducing milking duration. Furthermore, we found no evidence of interactions between the effects of switch-point and pulsator setting on milking duration, milk yield or milk flow rate., (© 2025, The Authors. Published by Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Background: Genetic breeding is essential to develop grapevine genotypes adapted to warm climates and resistant to pathogens. Traditionally cultivated Vitis vinifera is susceptible to biotic and abiotic stresses. Winemakers and consumers, however, perceive wines from non-vinifera or hybrid cultivars as inferior. In this study, sensory analyses and comprehensive metabolite profiling by targeted and untargeted approaches were used to investigate the oenological potential of wines from grapes of genotypes developed throughout four breeding cycles to improve climate adaptation, sugar contents and berry color., Results: Novel genotypes had higher yields and the wines exhibited increased contents of polyphenols, including anthocyanins. Volatile monoterpenes in the wines decreased throughout breeding cycles in the absence of selective pressure. Polyphenol contents were higher in intermediate wines, with hydroxytyrosol contents reaching up to three times reported values. Mouthfeel attributes astringency, leafy taste, flavor and body, and persistency showed significant correlation with untargeted features. Supervised model-based analyses of the metabolome effectively discriminate wines from distinct genetic origins., Conclusion: Taken together, the results demonstrate the potential of novel grapevine genotypes to a more sustainable viticulture and quality wine production in warm climates. Comprehensive metabolite profiling of the wines reveals that genotype clustering is dependent on the chemical class and that traits not submitted to selective pressure are also altered by breeding. Supervised multivariate models were effective to predict the genetic origin of the wines based on the metabolic profile, indicating the potential of the technique to identify biomarkers for wines from sustainable genotypes. © 2024 Society of Chemical Industry., (© 2024 Society of Chemical Industry.)

Background: The liver plays a central role in fat storage, but little is known about physiological fat accumulation during early development. Here we investigated a transient surge in hepatic lipid droplets observed in newborn mice immediately after birth., Methods: We developed a novel model to quantify liver fat content without tissue processing. Using high-resolution microscopy assessed spatial distribution of lipid droplets within hepatocytes. Lugol's iodine staining determined the timing weaning period, and milk deprivation experiments investigated the relationship between milk intake and fat accumulation. Lipidomic analysis revealed changes in the metabolic profile of the developing liver. Finally, we investigated the role of Toll-like receptor 4 (TLR4) signaling in fat storage using knockout mice and cell-specific deletion strategies., Results: Newborn mice displayed a dramatic accumulation of hepatic lipid droplets within the first 12 hours after birth, persisting for the initial two weeks of life. This pattern coincided with exclusive milk feeding and completely abated by the 3rd week, aligning with weaning. Importantly, the observed fat accumulation shared characteristics with established models of pathological steatosis, suggesting potential biological relevance. Lipid droplets were primarily localized within the cytoplasm of hepatocytes. Milk deprivation experiments demonstrated that milk intake is the primary driver of this transient fat accumulation. Lipidomic analysis revealed significant changes in the metabolic profile of newborn livers compared to adults. Interestingly, several highly abundant lipids in newborns were identified as putative ligands for TLR4. Subsequent studies using TLR4-deficient mice and cell-specific deletion revealed that TLR4 signaling, particularly within hepatocytes, plays a critical role in driving fat storage within the newborn liver. Additionally, a potential collaboration between metabolic and immune systems was suggested by the observed effects of myeloid cell-specific TLR4 ablation., Conclusions: This study demonstrates a unique phenomenon of transient hepatic fat accumulation in newborn mice driven by milk intake and potentially regulated by TLR4 signaling, particularly within hepatocytes., Competing Interests: Competing interests Authors declare that they have no competing interests., (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.)

The aim of this study was to investigate factors related to performance in daily activities, mobility, social/cognitive skills, and responsibility of Brazilian children/adolescents with cerebral palsy (CP). Multivariate binary logistic regression analyses were performed. A total of 190 children/adolescents participated. Most participants performed below expected in mobility, which could be explained by age, locomotion ability, and anatomical distribution of motor impairment (R 2  = 0.50). Performance in daily activities (R 2  = 0.44) and responsibility (R 2  = 0.23) were explained by age and locomotion ability. This study contributes to understanding the factors that explain the functioning of children/adolescents with CP in Brazil, a low/middle-income country.

Purpose: To evaluate the effect of diabetic retinopathy (DR) lesion type (hemorrhages and/or microaneurysms, intraretinal microvascular abnormalities, new vessels elsewhere, and venous beading), severity, and distribution on disease worsening based on the Early Treatment Diabetic Retinopathy Study Diabetic Retinopathy Severity Scale., Methods: Post hoc analysis of a multicenter observational study of 544 eyes with nonproliferative DR and an Early Treatment Diabetic Retinopathy Study Diabetic Retinopathy Severity Scale score of Level 35 to 53. Disease worsening was defined as Early Treatment Diabetic Retinopathy Study Diabetic Retinopathy Severity Scale worsening by ≥2 steps from baseline or receipt of DR treatment over 4 years. DR lesions were evaluated based on the entire visible area in the ultrawide field color (UWF-color) and UWF-fluorescein angiography images., Results: A significantly greater risk of disease worsening was associated with the presence of more severe lesion grades outside the Early Treatment Diabetic Retinopathy Study fields for hemorrhages and/or microaneurysms (hazard ratio: 1.74 [95% confidence interval, 1.28-2.36]) on UWF-color and for hemorrhages and/or microaneurysms (1.90 [1.38-2.61]), intraretinal microvascular abnormalities (1.68 [1.13-2.49]), and new vessels elsewhere (1.99 [1.36-2.93]) on UWF-fluorescein angiography., Conclusion: These results suggest that features on UWF-color and UWF-fluorescein angiography may provide additional prognostic value in determining the risk of disease worsening. The use of UWF-fluorescein angiography improves identification of DR lesions and disease progression. However, the optimal method of disease risk assessment on UWF imaging still needs to be determined.

Background: Drug-coated balloons (DCB) are emerging as an alternative to permanent implants for managing de novo coronary artery disease, particularly in small vessels (SVD). This sub-analysis of the PICCOLETO II study aimed to compare the performance of DCB and DES in terms of Murray's law-based quantitative flow ratio (μFR) changes between baseline, post-percutaneous coronary intervention (PCI), and follow-up., Methods: Patients with a clinical indication for PCI were assigned to receive either Xience DES or Elutax SV/Emperor DCB. Coronary angiograms were blindly analyzed by an independent Core Laboratory (Consorzio Futuro in Ricerca, University of Ferrara, Italy)., Results: Among 232 patients, 59 were included in this analysis. Pre-PCI μFR was comparable between groups (0.65 ± 0.29 vs. 0.58 ± 0.25; p = 0.20). Post-PCI, the DCB group had a lower acute functional gain compared to DES (+0.21 vs. +0.31; p = 0.064), with lower μFR values (0.86 ± 0.36 vs. 0.89 ± 0.3; p = 0.074). At 6-month follow-up, μFR values were similar between groups (0.84 ± 0.29 vs. 0.84 ± 0.31, p = 0.93), with a comparable late functional loss (-0.02 vs. -0.05; p = 0.93). Angiographic late lumen loss was significantly lower in the DCB group (-0.03 vs. +0.29 mm; p = 0.027)., Conclusions: DCB-based PCI showed a trend toward less favorable immediate post-PCI functional result but a comparable performance at follow-up, suggesting its potential in treating de novo SVD., (© 2024 Wiley Periodicals LLC.)

Ovariohysterectomy (OVH) is a common procedure in bitches, where ovarian suspensory ligament (OSL) rupture facilitates hemostasis but may also have adverse effects. Given the importance of minimizing the surgical stress response, this study aimed to evaluate the impact of OSL rupture in 20 healthy bitches undergoing elective open OVH; a celiotomy via the ventral midline was performed, and hemostasis achieved using bipolar coagulation, either with OSL rupture (OSL-R) or without (OSL-NR). Pain was assessed over 24 h post-surgery using the Visual Analogue Scale and the Short Form of the Glasgow Composite Measure Pain Scale. The physical parameters, complete blood count, glucose levels, erythrocyte sedimentation rate, and neutrophil oxidative and phagocytic functions were evaluated pre-surgery and at 6, 12, 24, and 48 h, as well as 10 days after. Oxidative metabolism was assessed through vitamin C and protein thiols, reduced glutathione, and thiobarbituric acid reactive substances. No differences in trans- and postoperative pain were observed between techniques, except for analgesic rescue rates. Differences were noted in the heart rate, total leukocyte count, segmented neutrophils, eosinophils, and monocytes. Both techniques resulted in low oxidative and phagocytic changes. Overall, OSL rupture appears to elicit a slightly more intense surgical stress response than the non-rupture technique.

Aedes aegypti is a vector responsible for the transmission of various arboviruses and is considered by the World Health Organization to be one of the main public health problems in the world. This study evaluated the larvicidal and oviposition activity of essential oils from Abies sibirica , Pogostemon cablin and Juniperus communis and their formulations. Chromatographic analysis by GCMS identified a total of 28, 52 and 18 compounds for the oils of the species A. sibirica , J. communis and P. cablin , respectively. The larvicidal bioassays showed an LC 50 of 67.53 ppm, 92.45 ppm and 35.95 ppm, respectively, for A. sibirica (A), J. communis (J) and P. cablin (P) as well as their binary (J + P, 39.50 ppm; A + P, 51.64 ppm) and ternary (A + J + P, 66.99 ppm) formulations. These oils and formulations also showed deterrent activity at the larvicidal concentrations tested ( A. sibirica : OAI: -0.41; J. communis : OAI: -0.31; P. cablin : OAI: -0.62; A + J + P: -0.30; A + P: -0.68; A + J: -0.29; and J + P: -0.30). The oils and their formulations are a potential larvicidal source for mitigating the proliferation of diseases by this vector.

Seaweed, traditionally part of the daily diet of Asian countries, has become a common dish in Western countries. In Brazil, although contributing to lesser amounts, seaweed consumption has been incorporated into the population eating habits. It is well established that seaweed contains (1) several biologically active components and (2) the ability to accumulate minerals and trace elements, both of which are essential and potentially toxic. Therefore, the objective of this study was to determine the concentrations of essential, trace and toxic elements present in edible seaweeds sold in São Paulo city market, considering the species, origin, and potential impact on the health of the consumers. Data demonstrated that the elemental distribution is characteristic of the species and due to low quantity consumption seaweed may be considered a reliable source for iodine alone.

Metarhizium is widely known for its role as an arthropod biocontrol agent and plant bioinoculant. By using mass-production industrial methods, it is possible to produce large amounts of fungal single-celled propagules (including blastospores) to be applied in the field. However, in the environment, the solar ultraviolet components (particularly UV-B) can harm the fungus, negatively impacting its pathogenicity toward the arthropod pest. The present study is the first to use comparative genome-wide transcriptome analyses to unveil changes in gene expression between Metarhizium pingshaense blastospores exposed or not to UV-B. Relative blastospores culturability was calculated 72 h after UV-B exposure and exhibited 100% culturability. In total, 6.57% ( n = 728) out of 11,076 predicted genes in M. pingshaense were differentially expressed after UV-B exposure: 320 genes (44%; 320/728) were upregulated and 408 (56%; 408/720) were downregulated in the UV-B exposed blastospores. Results unveiled differentially expressed gene sets related to fungal virulence, production of secondary metabolites, and DNA repair associated with UV damage; genes related to virulence factors were downregulated, and genes associated with nucleotide excision repair were upregulated. These findings illustrate critical aspects of Metarhizium blastospores strategies to overcome UV-B damage and survive solar radiation exposures in insulated fields., 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. The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Corval, Carvalho, Mesquita, Fiorotti, Corrêa, Bório, Carneiro, Pinheiro, Coelho, Santos, Fernandes, Angelo, Bittencourt and Golo.)

Objective: to assess the associations between cost-effectiveness analysis' (CEA) methodological characteristics and Incremental Cost-Effectiveness Ratio (ICER) outcomes and conclusions, in biological treatments for asthma., Study Design and Setting: We included CEAs comparing biological treatments to standard care, in adults with severe asthma. We performed a search in MEDLINE, EMBASE, and Web of Science (Sep 2022). We extracted and summarised CEA's characteristics and critically appraised the studies using the extended Consensus Health Economic Criteria (e-CHEC). In those reporting benefits as quality-adjusted life years (QALY), we conducted bivariate and regression analyses., Results: We identified 33 CEAs that showed overall good quality (above 66.6% of compliance) with variable results across e-CHEC sections. We included 28 cost-utility analysis (CUA) on biological treatments in asthma in our analysis. Only industry sponsorship showed significant differences in the bivariate analysis (p=0.021 for the difference in ICER medians, and p=0.027 for the different percentage in reported cost-effectiveness). In the regression adopting a non-lifetime horizon and non-use of a model (β = 4.25 and β = 0.16, p<0.05), significantly associated in the multivariate ananlysis. Only non industry sponsorship showed a significant association with the drug being reported as not cost-effective, both in the bivariate and multivariate analysis (OR = 13.2, and OR = 20.15 p<0.05)., Conclusion: Our study identified significant limitations, including poor reporting practices and the impact of industry sponsorship on outcomes, with notable effects on cost-effectiveness conclusions.These findings highlight the need for policymakers and healthcare decision-makers to meticulously consider methodological rigour and potential biases in economic evaluations., (Copyright © 2024. Published by Elsevier Inc.)

We aimed to evaluate performance, body development, metabolism, and expression of genes related to skeletal muscle hypertrophy in uncastrated male dairy kids fed with different levels of milk replacer (MR) during the preweaning period. Sixty newborn male kids, not castrated, from Saanen and Swiss Alpine breeds, with an average BW of 3.834 ± 0.612 kg, were distributed in a randomized block design. Breeds were the block factor in the model (random effect). Kids were allocated into 2 nutrition plans (n = 30 kids/treatment) categorized as follows: low nutritional plan (LNP; 1 L of MR/kid per day) or high nutritional plan (HNP; 2 L of MR/kid per day). All kids were harvested at 45 d of life. The majority of nitrogen balance variables were affected by the nutritional plan (P < 0.050). Morphometric measures and BCS (2.99 for LNP vs. 3.28 for HNP) were affected by nutritional plan (P < 0.050), except hip height, thoracic depth, and hip width. The nutritional plan affected the body components (P < 0.050), except esophagus and trachea. Animal performance and carcass traits were influenced by nutritional plan (P < 0.050), except carcass dressing (48.56% on average). Nutritional plan affected (P < 0.050) some blood profile variables as the total cholesterol (141.35 vs. 113.25 mg/dL), triglycerides (60.53 vs. 89.05 mg/dL), LDL (79.76 vs. 33.66 g/mL), and IGF-1 (17.77 vs. 38.55 ng/mL) for LNP and HNP, respectively. Hypertrophy was greater in HNP than LNP animals (P < 0.050), being represented by the proportion of sarcoplasm (39.76% vs. 31.99%). LNP had a greater mTOR abundance than HNP (P = 0.045), but AMPK was not affected by the nutritional plan. Our findings show that a higher milk replacer allowance enhances animal performance, body development, metabolic parameters, and cellular hypertrophy in preweaning dairy kids., (© 2024, The Authors. Published by Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Aedes aegypti transmits the arboviruses that cause dengue, zika, and chikungunya. Entomopathogenic fungi are beneficial microorganisms that can be incorporated into current strategies against mosquitoes of public health concern. This study molecularly identified the Metarhizium anisopliae CG 153 isolate and evaluated its virulence against larvae, pupae, and adults (both males and females) of Ae. aegypti. Different concentrations of conidia were used (1 × 10 4-8 conidia mL -1 ). Larval and pupal survival was monitored daily for seven and three days, respectively, while adults were monitored for 15 days. The efficacy of M. anisopliae sensu stricto was concentration-dependent, with higher concentrations achieving better results, demonstrating greater virulence against larval and adult stages of Ae. aegypti. The fungus reduced the larval survival by 95,5% (1 × 10 8 con.mL -1 ), 94,4% (1 × 10 7 con.mL -1 ), 78,9% (1 × 10 6 con.mL -1 ), 62,2% (1 × 10 5 con.mL -1 ), and 41,1% (1 × 10 4 con.mL -1 ) after seven days. Adults also showed susceptibility to the fungus, with no observed difference in susceptibility between males and females. Over 15 days of monitoring, adult survival rates ranged from approximately 6.7% to 72%. Pupae exhibited lower susceptibility to the fungus across different concentrations, with survival rates ranging from approximately 87.8% to 100%. This study highlights the high effectiveness of M. anisopliae CG 153 against both Ae. aegypti larvae and adults (male and female) under controlled conditions, suggesting its promising potential for further evaluation and application in field conditions., (© 2024. Sociedade Entomológica do Brasil.)

Introduction: Amphotericin B lipid complex (ABLC) is an effective antifungal agent for treating invasive fungal infections (IFIs) even though its formulation is associated with potential adverse events, including those related to its infusion. This study aimed to analyze the incidence of acute infusion-related side effects (IRSE) associated with ABLC and their relationship with the profile of patients with oncohematological disease admitted in Brazilian reference tertiary hospitals., Methods: This is an observational retrospective study that included clinical records of patients hospitalized, in a period of 6 years, diagnosed with probable or proved IFI and treated with at least two doses of ABLC., Results: A total of 229 patients were included, with a male prevalence and an average age of 44 years for adults and 10 years for children. Seventy-nine (34.5%) developed some IRSE, 5.1% of which progressed in severe form to discontinuation of treatment. The most prevalent events in adults were fever (66.7%), tremor/chills (53.3%), and tachycardia (24.4%). In children, the most common were fever (64.7%), tremors/chills (50%), and skin rash/itching (17.6%). Statistical significance was found for premedication use from the first dose of ABLC in relation to the onset of infusion reactions (P = 0.006). Multivariate analysis revealed that ABLC, when compared to liposomal AMB (L-AMB), and neutropenia were associated with a higher risk of developing IRSE (odds ratio [OR] 3.04, P = 0.008; and OR 11.02, P = 0.025, respectively)., Conclusions: The use of premedication was a protective factor against the occurrence of IRSE. Therefore, services providing amphotericin B (AMB) must reinforce protocols or implement new measures that optimize tolerability and safety during the treatment of patients with oncohematological disease, with special attention to patients with neutropenia, prioritizing the liposomal formulation of AMB whenever possible., Competing Interests: Declarations. Conflict of Interest: Francelise Bridi Cavassin, Marcello Mihailenko Chaves Magri, Ariela Victoria Borgmann, Isabela Dombeck Floriani, Marina Rachid Barreto, Tania Zaleski, Fabianne Altruda de Moraes Costa Carlesse, Giovanni Luís Breda, Fábio de Araújo Motta, Diego Rodrigues Falci, Ana Verena Almeida Mendes, Hugo Paz Morales, Patrícia Silva Montes, Mariane Taborda, Talita Teles Teixeira Pereira, João Luís Baú-Carneiro, Flávio Queiroz-Telles declare no conflicts of interest for this specific study. Ethical Approval: Consent to use the data was obtained in all centers. Approval was granted by the ethics committees of the seven participating centers, with the Complexo Hospital de Clínicas of the Federal University of Paraná (CHC/UFPR) being the study’s coordinating center., (© 2024. The Author(s).)

Objective: This study aims to evaluate whether obstructive or restrictive lung disorders are associated with the incidence of dynapenia in individuals aged 50 and over., Methods: Longitudinal study involving 4,975 participants from the English Longitudinal Study of Aging (ELSA) aged 50 or older, without dynapenia at baseline, followed for eight years. Lung function was assessed by spirometry (predicted percentage) and participants were classified as no pulmonary disorder (FEV 1 ≥ 80 %, FVC ≥ 80 % and FEV 1 /FVC ≥ 70 %); with obstructive pulmonary disorder (FEV 1 < 80 %, FEV 1 /FVC < 70 % and normal FVC or < 80 %); or with restrictive pulmonary disorder (FVC < 80 %, FEV 1 /FVC > 70 % and normal or < 80 % FEV 1 ). The incidence of dynapenia was defined by handgrip strength < 26 kg for men and < 16 kg for women. Association between obstructive or restrictive pulmonary disorders and the incidence of dynapenia were investigated using Poisson regression models adjusted for sociodemographic, behavioural, and clinical characteristics., Results: The incidence density of dynapenia was 14.2/1000 person-years (95 %CI 12.6-15.9) in those without pulmonary disorders, 25.1/1000 person-years (95 % CI 21.2-29.7) in those with restrictive pulmonary disorders and 36.6/1000 person-years (95 % CI 23.8-56.1) in those with obstructive pulmonary disorders. Having an obstructive pulmonary disorder increased the risk of developing dynapenia by 62 % (95 % CI 1.09-2.41), while having a restrictive pulmonary disorder increased the risk by 37 % (95 % CI 1.13-1.64)., Conclusion: Obstructive and restrictive pulmonary disorders are risk factors for a higher incidence of dynapenia in individuals aged 50 years or older., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)

Background: Sarcopenic obesity is a condition where loss of muscle mass occurs alongside fat gain, and it is considered a risk factor for mortality. However, the use of various definitions for this condition has led to conflicting results., Aim: To investigate whether the coexistence of low muscle mass and abdominal obesity, defined using two simple measures employed in clinical practice, is a risk factor for mortality in individuals aged 50 or older., Methods: A longitudinal study with a 14-year follow-up was conducted involving 5,440 participants of the English Longitudinal Study of Ageing. Abdominal obesity and low muscle mass were respectively defined based on high waist circumference and low skeletal muscle mass index (SMMI) determined by an equation. The sample was divided into four groups: non-low muscle mass/non-abdominal obesity (NLMM/NAO), non-low muscle mass/abdominal obesity (NLMM/AO), low muscle mass/non-abdominal obesity (LMM/NAO), and low muscle mass/abdominal obesity (LMM/AO). Cox regression models were used to estimate the mortality risk as a function of muscle mass and abdominal obesity status., Results: LMM/AO increased the risk of death by 83% (HR:1.83; 95%CI: 1.35-2.66) compared to those in the NLMM/NAO group. AO alone was not associated with a greater risk of mortality (HR:1.09; 95%CI: 0.93-1.27), whereas LMM alone increased the risk by 40% (HR:1.40; 95%CI:1.18-1.66)., Conclusions: Identifying LMM/AO in individuals aged 50 or older can be crucial for predicting the risk of mortality. Simple and easily applicable measures can serve as a proxy for sarcopenic obesity and aid in implementing the necessary interventions., Competing Interests: Declarations Ethical approval and informed consent The English Longitudinal Study of Ageing received approval from the National Research Ethics Service [London Multicentre Research Ethics Committee (MREC/01/2/91)]. All participants signed a statement of informed consent. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Native starches have a high potential for producing capsules by electrospraying despite still being little explored as biopolymeric material. Thus, the present study aimed to investigate the electrospraying capacity of native starches from different sources (cassava, corn, wheat, and sweet potato). The concentration of starch in the polymer solutions was varied from 3 % to 10 % (w/v) to investigate the impact of both starch source and concentration on the electrospraying process. The study also aimed to deepen scientific knowledge of the behavior of these starches during the process and the characteristics of the resulting capsules. The characterization of the polymeric solutions was carried out regarding rheology and electrical conductivity and the capsules were evaluated by production yield, morphology, size distribution, thermal properties, and crystallinity. Higher viscosities were observed for polymeric solutions obtained from sweet potato starch, compared to other starches at the same polymer concentrations. The increase in starch concentration in polymeric solutions reduced their electrical conductivity, except for corn starch. The production yield of cassava and sweet potato starch capsules was not affected by the polymer concentration in the polymeric solutions, while for corn and wheat starches, there was a reduction in yield as the concentration increased. All starches were able to form capsules. Capsules produced with 7 % corn starch showed a more homogeneous size distribution. The electrosprayed starches showed elevated melting temperatures and enthalpies. The capsules produced had an amorphous structure. The starches evaluated in this study proved to be excellent biopolymers for producing capsules by electrospraying, demonstrating possible future uses as encapsulating materials., 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 B.V. All rights reserved.)

Objectives: Investigate whether and which synoviocytes would acquire trained immunity characteristics that could exacerbate joint inflammation following a secondary Staphylococcus aureus infection., Methods: Lipopolysaccharide (LPS) and S. aureus were separately or double injected (21 days of interval) into the tibiofemoral joint cavity of male C57BL/6 mice. At different time points after these stimulations, mechanical nociception was analyzed followed by the analysis of signs of inflammation and damage in the affected joints. The trained immunity markers, including the glycolytic and mTOR pathway, were analyzed in whole tissue or isolated synoviocytes. A group of mice was treated with Rapamycin, an mTOR inhibitor before LPS or S. aureus stimulation., Results: The double LPS - S. aureus hit promoted intense joint inflammation and damage compared to single joint stimulation, including markers in synoviocyte activation, production of proinflammatory cytokines, persistent nociception, and bone damage, despite not reducing the bacterial clearance. The double LPS - S. aureus hit joints increased the synovial macrophage population expressing CX3CR1 alongside triggering established epigenetic modifications associated with trained immunity events in these cells, such as the upregulation of the mTOR signaling pathway (p-mTOR and HIF1α) and the trimethylation of histone H3. Mice treated with Rapamycin presented reduced CX3CR1 + macrophage activation, joint inflammation, and bone damage., Conclusions: There is a trained immunity phenotype in CX3CR1 + synovial macrophages that contributes to the exacerbation of joint inflammation and damage during septic arthritis caused by S. aureus., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Ethnopharmacological Relevance: Echinodorus macrophyllus is a medicinal plant traditionally used in Brazil to treat rheumatic diseases. It is listed as a priority species for the development of herbal preparations for the Brazilian Unified Health System (SUS). Previous studies have demonstrated the anti-inflammatory and antiedematogenic properties of extracts and fractions from this species, but these preparations were neither standardized nor optimized for anti-arthritis effects., Aim of Study: This study aimed to investigate the anti-inflammatory and antiarthritic effects of various standardized extracts from the aerial parts of E. macrophyllus and to outline their mechanisms of action. The goal was to define an extract suitable for future scientific validation and clinical use., Material and Methods: Extracts from the aerial parts of E. macrophyllus were prepared through percolation with 96°GL ethanol (EtOH) and hydroethanolic solutions at 90%, 70%, and 50% (v/v). They were standardized based on the contents of six chemical markers quantified by UPLC-DAD. Mice with acute or chronic antigen-induced arthritis (AIA) were treated with the extracts orally. The effects were evaluated by counting total and differential inflammatory cells, measuring cytokines by ELISA, and by histological analysis with toluidine blue staining. The mechanism of selected extracts was investigated in LPS-stimulated murine chondrocytes., Results: All extracts, except for the 90% EtOH extract, exhibited significant anti-inflammatory activity in acute AIA, reducing the migration of total inflammatory cells, neutrophils, and monocytes to the intra-articular cavity. In chronic AIA, both the 96°GL EtOH and 70% EtOH extracts markedly reduced the migration of total inflammatory cells, neutrophils, and monocytes to the intra-articular cavity, decreased IL-1β and CXCL1 levels in the periarticular tissue, and diminished proteoglycan loss in the articular cartilage. Both extracts reduced IL-6 release and MMP-3 expression in LPS-stimulated chondrocytes. The 70% EtOH and 50% EtOH extracts showed heightened activity and higher levels of chemical markers, notably cinnamoyl-tartaric acid derivatives., Conclusions: The standardized 70% EtOH and 50% EtOH extracts from the aerial parts of E. macrophyllus, which contain higher levels of chemical markers, exhibit potent anti-inflammatory activity and reduce proteoglycan degradation. These extracts are potentially useful for developing herbal preparations to manage arthritic conditions and should be prioritized for further studies., 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 B.V. All rights reserved.)

Aim: To map the ingredients of non-invasive interventions provided to young ambulant children with cerebral palsy., Method: Articles were screened and each study's characteristics extracted. The intervention ingredients were described in terms of the Rehabilitation Treatment Specification System and linked to the 'F-words'. Results were interpreted and validated by a patient and public involvement group., Results: Sixty-one papers were included, of which 55.5% were classified as randomized controlled trial design studies. The selected studies included a total of 2187 children (mean age range 3 months to 5 years 11 months), most from high-income countries. The included studies investigated a total of 27 interventions, which together presented ingredients representing all F-words, in the following order of frequency: 'fitness' (e.g. strength and endurance training), 'functioning' (e.g. active and repetitive practice of a task), 'family' (e.g. context-focused therapy), 'fun' (e.g. inclusion of child-friendly activities), 'friends' (e.g. group activities), and 'future' (e.g. didactic information sharing). Thus, ingredients related to the F-word 'future' were the most infrequently reported., Interpretation: Therapists and families need to be aware of the most appropriate match between the F-word goals, ingredients, and targets. Finally, 'fun', 'friends', and 'future' should be addressed as potential outcomes in future studies., (© 2024 Mac Keith Press.)

Objectives: Investigate whether the coexistence of pain and depressive symptoms is a risk factor for cognitive decline in individuals aged 50 or older., Method: Longitudinal trajectory study involving 4,718 participants from the English Longitudinal Study of Ageing (ELSA). Joint pain was self-reported, and intensity was classified as mild, moderate/intense. Depressive symptoms were investigated using the Centre for Epidemiologic Studies Depression Scale ( CES-D-8  ≥ 4). The sample was divided into six groups: no pain and no depression (NP/NDe), mild pain and no depression (MP/NDe), moderate/intense pain and no depression (M-IP/NDe), no pain and depression (NP/De), mild pain and depression (MP/De), and moderate/intense pain and depression (M-IP/De). The outcome of interest was performance in memory, executive function, and global cognition. Generalised linear mixed models were used to analyse performance in the cognitive domains and global cognition score as a function of pain and depressive symptoms during 12 years of follow-up., Results: Over time, individuals with M-IP/De had a greater memory decline (-0.038 SD/year, 95%CI: -0.068 to -0.007) and the global cognition score (-0.033 SD/year, 95%CI: -0.063 to -0.002) than those with NP/NDe., Conclusion: The coexistence of moderate/intense pain and depressive symptoms is a risk factor for the decline of global cognition and memory.

Objectives: This study investigated antibiotic resistance and presence of persister cells in Streptococcus agalactiae strains belonging to capsular types Ia/ST-103, III/ST-17, and V/ST-26 in biofilm-like environments. Results: S. agalactiae strains were susceptible to penicillin, clindamycin, and erythromycin. Resistance genes were associated with tet M (80%), tet O (20%), erm B (80%), and lin B (40%). Persister cells were detected in bacterial strains exposed to high concentrations of penicillin, clindamycin, and erythromycin. S. agalactiae capsular type III/ST-17 exhibited the highest percentage of persister cells in response to penicillin and clindamycin, while type Ia/ST-103 presented the lowest percentages of persister cells for all antimicrobials tested. Additionally, persister cells were also detected at lower levels for erythromycin, regardless of capsular type or sequence type. Further, all S. agalactiae isolates presented efflux pump activity in ethidium bromide-refractory cell assays. LIVE/DEAD fluorescence microscopy confirmed the presence of >85% viable persister cells after antibiotic treatment. Conclusions: These findings suggest that persister cells play a key role in the persistence of S. agalactiae during antibiotic therapy, interfering with the treatment of invasive infections. Monitoring persister formation is crucial for developing strategies to combat recurrent infections caused by this pathogen.

The cattle tick Rhipicephalus (Boophilus) microplus (Canestrini, 1887) (Ixodida, Ixodidae) is responsible for significant economic losses in bovine production in tropical and subtropical regions worldwide. Control of this tick predominantly involves the use of chemical acaricides; however, their indiscriminate use has led to the selection of resistant populations. A survey on tick populations was conducted in the state of Rio Grande do Sul, in Brazil, to assess the prevalence of multiple resistance to acaricides in cattle farms. Additionally, questionnaires were administered to identify potential risk factors associated with multiple resistance to acaricides. In total, 176 farms with a bovine population of ≥40 cattle were randomly assigned for tick sampling. The resistance to six acaricidal compounds was investigated by bioassays. A larval packet test was performed for amitraz, chlorpyrifos, cypermethrin, fipronil and ivermectin. Fluazuron was screened using an adult immersion test. Multiple resistance to acaricides (i.e., resistance to three or more compounds) was detected in 173 samples, representing 98% of the total samples. Among these samples, 125 (71%) showed resistance to all six compounds tested. Additionally, we classified the resistance intensity into four levels (I to IV) based on the quartile distribution of the bioassay data. Ten samples (6%) showed high and very high levels (III and IV) of resistance to all six compounds tested. Three variables were significantly associated with multiple resistance to the six acaricides tested: (i) use of injectable acaricides to control ticks, (ii) application of more than five acaricide treatments per year, and (iii) farms with larger herds (≥232 animals). These results regarding widespread resistance and the emergence of multiple resistance to acaricides ticks are alarming and highlight the significant challenge of tick control in southern Brazil., (© 2024 Royal Entomological Society.)

Children with Cerebral palsy (CP) present movement and posture disorders. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), Eating and Drinking Ability Classification System (EDACS), and Visual Function Classification System (VFCS) enhance the understanding of their performance. We verified inter-rater reliability and associations between the classification levels. Physical therapists classified 100 Brazilian children with CP (3-17 years) according to GMFCS, MACS, CFCS, EDACS, and VFCS. To evaluate inter-rater reliability (Intraclass Correlation Coefficient-ICC) two independent examiners concurrently assessed a subset of 60 participants. According to Spearman's correlation coefficients, there were associations between GMFCS/MACS ( r  = 0.81), GMFCS/CFCS ( r  = 0.70), MACS/CFCS ( r  = 0.73), GMFCS/VFCS ( r  = 0.61), MACS/VFCS ( r  = 0.61), CFCS/EDACS ( r  = 0.58), CFCS/VFCS ( r  = 0.50), and EDACS/VFCS ( r  = 0.45) ( p  < .05). The inter-rater reliability ranged from excellent (ICC = 0.93-0.99) to good (ICC = 0.89), p  < .05. The classification systems are reliable, and the levels associated with each other in Brazilian children, especially the GMFCS, MACS, and CFCS.

Congenital Chagas disease (CCD) is a worldwide neglected problem with significant treatment limitations. This study aimed to evaluate the potential of Copaifera spp. oleoresins (ORs) against Trypanosoma cruzi infection in trophoblast cells (BeWo lineage) and human chorionic villous explants (HCVE). The cytotoxicity of ORs was investigated using LDH and MTT assays. T. cruzi (Y strain) proliferation, invasion and reversibility were assessed in OR-treated BeWo cells, and proliferation was evaluated in OR-treated HCVE. The ultrastructure of T. cruzi trypomastigotes and amastigotes treated with ORs were analyzed by scanning and transmission electronic microscopy. ROS production in infected and treated BeWo cells and cytokines in BeWo and HCVE were measured. The ORs irreversibly decreased T. cruzi invasion, proliferation and release in BeWo cells by up to 70 %, 82 % and 80 %, respectively, and reduced parasite load in HCVE by up to 80 %. Significant structural changes in treated parasites were observed. ORs showed antioxidant capacity in BeWo cells, reducing ROS production induced by T. cruzi infection. Also, T. cruzi infection modulated the cytokine profile in both BeWo cells and HCVE; however, treatment with ORs upregulated cytokines decreased by T. cruzi infection in BeWo cells, while downregulated cytokines increased by the T. cruzi infection in HCVE. In conclusion, non-cytotoxic concentrations of Copaifera ORs demonstrated promising potential for controlling T. cruzi infection in models of the human maternal-fetal interface., 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 Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Background: Catheter ablation (CA) is a well-established treatment for atrial fibrillation (AF). However, its effects on autonomic function and underlying mechanisms remain poorly understood. This study investigated autonomic and haemodynamic changes following CA and explored their potential implications for patient outcomes. Methods : Seventy-eight patients with AF underwent CA and were followed up at one, three, and six months. Autonomic function was assessed using a combination of head-up tilt (HUT), handgrip (HG), and deep breathing (DB) manoeuvres along with baroreflex sensitivity (BRS) and baroreflex effectiveness index (BEI) evaluation. Heart rate (HR), blood pressure (BP), and their variability were measured at each time point. Results : Significant autonomic alterations were observed after ablation, particularly at one month, with reductions in parasympathetic tone and baroreflex function. These changes gradually normalised by six months. Both pulmonary vein isolation (PVI) and cryoablation (CryO) had similar effects on autonomic regulation. Improvements in quality of life, measured by the AFEQT scores, were consistent with these physiological changes. Conclusions: CA for AF induces significant time-dependent autonomic and haemodynamic changes with recovery over six months. These findings underscore the need for ongoing monitoring and personalised post-ablation management. Further research is required to explore the mechanisms driving these alterations and their long-term impacts on patient outcomes.

Following the 2022 global mpox outbreak, diagnoses decreased worldwide, even in settings with limited vaccine access. In 2023-2024, a new outbreak emerged in Rio de Janeiro, Brazil, highlighting the importance of continuous surveillance, preventive measures such as vaccination in vulnerable populations, and treatment options, emphasizing equitable global health technology distribution., Competing Interests: Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Healthcare-associated infections (HAIs) pose significant challenges to global health due to pathogen complexity and antimicrobial resistance. Biosensors utilizing antimicrobial peptides offer innovative solutions. Hylarana picturata Multiple Active Peptide 1 (Hp-MAP1), derived from Temporin-PTA, exhibits antibacterial properties sourced from the skin secretions of the Malaysian fire-bellied frog. An innovative sensing layer was developed for the electrochemical biorecognition of diverse pathogens: Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus. Electrochemical impedance spectroscopy differentiated microorganisms based on distinct electrochemical responses. The sensor layer, composed of functionalized multi-walled carbon nanotubes (MWCNTs) associated with Hp-MAP1, exhibited varying levels of charge transfer resistance (R CT ) for different microorganisms. Gram-negative species, especially P. aeruginosa, displayed higher R CT values, indicating better impedimetric responses. Excellent LODs were observed for P. aeruginosa (0.60), K. pneumoniae (0.42), E. coli (0.67), and S. aureus (0.59), highlighting the efficacy of the MWCNTs/Hp-MAP1 biosensor in microbial identification. The MWCNTs/Hp-MAP1 biosensor platform presents a promising and effective microbial identification strategy with potential healthcare applications to mitigate HAIs and enhance patient care., (© 2024 American Institute of Chemical Engineers.)

Background and Objectives: Atrial fibrillation (AF) is increasingly recognised in paediatric patients, presenting unique challenges in management due to its association with various underlying heart conditions. This study aimed to evaluate the prevalence, management strategies, and outcomes of AF in this population. Materials and Methods : A retrospective analysis was conducted at a tertiary paediatric cardiology centre, including patients aged ≤18 years diagnosed with AF between January 2015 and December 2023. The study focused on demographic details, clinical presentations, treatments, and outcomes. Descriptive statistics were employed to assess treatment efficacy, recurrence rates, and complications. Results : The study included 36 paediatric patients (median age: 15 years, IQR: 13-17; 58% male). Of these, 52.8% had acquired heart disease, 16.7% had congenital heart anomalies, and 16.7% presented with lone AF. The initial management strategies involved electrical cardioversion in 53.3% of patients and pharmacological conversion with amiodarone in 46.7%. Rhythm control therapy was administered to over 80% of the cohort, and 63.9% were placed on oral anticoagulation, predominantly for rheumatic and congenital heart diseases. The overall success rate of rhythm control was 96.2%, with an AF recurrence rate of 3.8%. Ischemic stroke was the most common complication, occurring in three patients, all with underlying rheumatic heart disease. Conclusions : AF in paediatric patients is predominantly associated with rheumatic and congenital heart diseases, though a significant proportion of patients present with lone AF. Despite effective rhythm control in most cases, neurological complications, particularly ischemic strokes in patients with underlying heart disease, remain a critical concern. These findings underscore the need for more comprehensive studies to better understand the aetiology, risk factors, and optimal management strategies for paediatric AF.