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Fabiano Nadson Magacho-Vieira,1,2 Abrahao Osta Vieira,3 Amarilho Soares Jr,4 Hellise Christine Lana Alvarenga,5 Iran Roger Alkimin de Oliveira Junior,6 João Antonio Correa Daher,7 João Vitor Moraes Pithon Napoli,8 Júlia Portocarrero de Almeida Serra,9 Suellen Costa Provázio10 1Magacho Institute for Health Education, Fortaleza, CE, Brazil; 2Department of Clinical, Aesthetic and Surgical Dermatology, Batista Memorial Hospital, Fortaleza, CE, Brazil; 3Clínica Abrahão Osta, Pedro Leopoldo, MG, Brazil; 4Clínica Amarilho Jr, Americana, SP, Brazil; 5Núcleo Lana, Nova Lima, MG, Brazil; 6Iran Alkimin Dermatologia, São Paulo, SP, Brazil; 7Daher Núcleo de Estética, São Paulo, SP, Brazil; 8Instituto Pithon Napoli, São Paulo, SP, Brazil; 9JS Dermatologia, Campo Grande, MS, Brazil; 10Instituto Pedro Miranda, Goiânia, GO, BrazilCorrespondence: Fabiano Nadson Magacho-Vieira, Instituto Magacho de Ensino em Saúde, Avenida Santos Dumont, 5753, Sala 204, Fortaleza, CE, 60175-047, Brazil, Tel +55 85 99788-0002, Email contato@institutomagacho.com.brAbstract: Poly-D,L-lactic acid (PDLLA) microspheres, marketed globally as Aesthefill® (Regen Biotech, Seoul, South Korea), are recognized for their biocompatible and biostimulatory properties, positioning them as a preferred option in aesthetic medicine. This article presents consensus recommendations from Brazilian experts on the reconstitution and clinical application of PDLLA for facial and non-facial treatments. Developed using a modified Delphi method with contributions from leading dermatologists and plastic surgeons, the consensus outlines protocols for reconstitution, injection techniques, and patient management. Key recommendations include reconstitution with 7– 8 mL of sterile water for injection, the addition of lidocaine to improve patient comfort, and a preference for targeting the superficial subcutaneous layer. Dosing guidelines are specifically tailored to each treatment area and the desired degree of correction, underscoring the importance of personalized treatment plans. Maintenance treatments are advised at biennial intervals or at shorter intervals for patients exhibiting accelerated collagen degradation. The consensus also highlights the need for proper training and patient screening to minimize adverse effects, such as nodules and granulomas. This comprehensive guide aims to standardize the use of PDLLA, prioritizing patient safety and optimizing outcomes. While clinical trials evaluating PDLLA’s aesthetic indications remain limited, these evidence-based guidelines bridge the gap by offering practical protocols grounded in clinical expertise. Further research is encouraged to validate these recommendations and explore new applications for PDLLA in aesthetic medicine.Plain Language Summary: Poly-D, L-lactic acid (PDLLA) microspheres are small particles used in aesthetic medicine to improve skin appearance by stimulating collagen production. This summary outlines expert recommendations from experts on preparing and using PDLLA for facial and body treatments.Why was the study done?The study aimed to create standardized guidelines to help practitioners achieve the best results and ensure patient safety when using PDLLA for cosmetic purposes.What did the researchers do and find?They used a method called the Delphi approach to gather and refine recommendations on the reconstitution and injection of PDLLA. By consensus, the experts who participated in this study recommend using of sterile water for injection to prepare the PDLLA and adding lidocaine to reduce discomfort during injections. Specific techniques, such as linear retrograde and fanning methods, are advised for different areas of the face and body. The experts have also provided dosing guidelines and emphasize the need for individualized treatment plans.What do these results mean?The recommendations help practitioners use PDLLA more effectively and safely, providing better aesthetic outcomes for patients. Regular maintenance treatments are suggested every two years, with more frequent sessions for those with faster collagen loss. Proper training and careful patient screening are essential to avoid complications such as nodules or granulomas.Keywords: poly-D,L-lactic acid, polylactic acid, collagen stimulator, consensus, expert recommendations, filler

OBJECTIVE: To compare single-photon-emission computed tomography (SPECT) imaging scans using 201Tl and 99mTc-MIBI in detection of viable myocardium, in regions compromised by infarction. METHODS: Thirty-two (59.3±9.8 years old and 87% male) myocardial infarction patients were studied. All had Q waves on the ECG and left ventricle ejection fraction of

BackgroundRecent data suggest that breast-conserving surgery (BCS) may positively impact overall survival (OS) in early breast cancer. However, the role of BCS in locally advanced breast cancer (LABC) following neoadjuvant therapy (NAT) remains uncertain.MethodsWe conducted a retrospective cohort study involving 530 LABC patients who underwent surgery after NAT between 2010 and 2015. Outcomes examined included OS, distant recurrence rates (DRR), and loco-regional recurrence rates (LRRs).ResultsAmong the 927 breast cancer patients who received NAT, 530 were eligible for our study. Of these, 24.6% underwent BCS, while 75.4% underwent mastectomy (MS). The median follow-up duration was 79 months. BCS patients exhibited a higher pathological complete response (PCR) rate compared to those who underwent MS (22.3% vs. 10%, p < 0.001). The 6-year OS rates for BCS and MS were 81.5% and 62%, respectively (p < 0.000). In multivariate OS analysis, MS was associated with worse outcomes (OR 1.678; 95% CI 1.069–2.635; p = 0.024), as was body mass index (BMI) (OR 1.031; 95% CI 1.006–1.058; p = 0.017), and stage IIIB or IIIC (OR 2.450; 95% CI 1.561–3.846; p < 0.000). Conversely, PCR (OR 0.42; 95% CI 0.220–0.801; p = 0.008) was associated with improved survival. DRR was significantly lower in BCS (15.4%) compared to MS (36.8%) (OR 0.298; 95% CI 0.177–0.504). LRRs were comparable between BCS (9.2%) and MS (9.5%) (OR 0.693; 95% CI 0.347–1.383).ConclusionOur findings suggest that BCS is oncologically safe, even for patients with large lesions, and is associated with superior OS rates compared to MS. Additionally, lower BMI, lower pretreatment stage, and achieving PCR were associated with improved survival outcomes.

Melatonin is an indoleamine with crucial antioxidant properties that are used to combat inflammatory and neoplastic processes, as well as control transplants. However, the clinical applications of melatonin have not yet been fully consolidated in the literature and require in-depth analysis. Objectives: This study reviewed the literature on the antioxidant properties of melatonin in rat models. Methods: We followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses and used the PubMed, LILACS, and Cochrane databases, Google Scholar, and article references, irrespective of publication time. Results: Ten articles involving 485 rats were selected, and the effects of melatonin on antioxidant markers were investigated. Melatonin increased superoxide dismutase in nine studies, glutathione peroxidase in seven studies, and catalase in five studies. In contrast, melatonin reduced glutathione in three studies and malonaldehyde in seven of eight studies. Conclusion: Our findings suggest that melatonin effectively reduces oxidative stress.

Background: Many students struggle with mathematics difficulties, such as arithmetic problem-solving, intuitive geometry concepts and learning disabilities. Currently, there is an increasingly interesting in applying neuroscientific research paradigms to elucidate mathematical thinking and neural mechanisms that underlie academic achievement. On this matter, eye-tracking technology has been a valuable option for educational research. It provides a non-invasive and real-time measurement of participants’ eye movements and pupil sizes during cognitive tasks. Moreover, the eye-tracker device is portable, allowing more ecological educational experimentations. Aim: Our main goals are to provide an overview and different opportunities for educational eye-tracking research to investigate mathematical thinking at schools. Setting: This study was conducted in Sao Bernardo do Campo, Sao Paulo, Brazil. Methods: This is a perspective article that briefly introduces the eye-tracking technique and describes its possible use in educational research. Results: We present the popular measures and the trends of this technology that could enable educational practitioners and scientists to apply the eye-tracking system to benefit teaching and learning mathematics in naturalistic research. Conclusion: The eye-tracking provides insights for innovative approaches to promote evidence-based practices and new interventions through self-directed learning and metacognition skills that could be helpful in mathematics education. Contribution: This article provides insight into eye-tracking system utility in educational research regarding the mathematics teaching–learning process.

Objective: To analyze differences in the menstrual pattern, age at menarche, and body mass index (BMI) in adolescents with Hypothalamic-Pituitary-Ovarian (HPO) axis immaturity and Polycystic Ovary Syndrome (PCOS) through a systematic review and meta-analysis. Methods: The PubMed, EMBASE, Web of Science, Virtual Health Library, Scopus databases were searched using combinations of descriptors. Study quality was assessed using the Newcastle-Ottawa Scale. For data analysis, the results were grouped into PCOS group and NPCOS group (HPO axis immaturity). We performed a meta-analysis of raw data and the inverse variance method, employing the standardized mean difference, of the age at menarche and BMI of adolescents. Results: Participants totaled 1,718 from nine selected studies. The meta-analysis showed that the PCOS group had a higher BMI than the NPCOS group (SMD 0.334; CI95% 0.073 − 0.595; p =.012). The degree of heterogeneity of the studies was approximately 40%. No significant difference in age at menarche (SMD − 0.027; CI95% −0.227 − 0.172; p = 0.790) and menstrual patterns was found, but amenorrhea was described only in adolescents with PCOS. Conclusions: The main characteristic in menstrual pattern that differentiated PCOS patients from girls with HPO axis immaturity was amenorrhea. Also, the BMI of PCOS patients was nearly one third higher than that of adolescents with HPO axis immaturity. [ABSTRACT FROM AUTHOR]

Integrating neuroscience techniques, such as eye tracking, into educational practices has opened new avenues for understanding the cognitive processes underlying learning. This study investigates the feasibility and practicality of using eye tracking as a supportive tool for educators in primary school settings. By taking into account eye-tracking features in lesson plans and instruction, this study explores the benefits and challenges of this technology from teachers' perspective. The findings reveal that eye tracking can enhance interactivity, maintain student attention, and provide immediate feedback, thereby aiding in identifying student difficulties that may otherwise go unnoticed. However, the study also highlights concerns related to technical complexities, data privacy, and the need for teacher training to utilize and interpret eye-tracking data effectively. These insights contribute to a nuanced understanding of how eye-tracking technology can be implemented in educational settings, offering potential pathways for personalized teaching and improved learning outcomes. [ABSTRACT FROM AUTHOR]

Background: We followed polycystic ovary syndrome (PCOS) women with metabolic syndrome (MS) over a six-year treatment period and evaluated the influence of PCOS phenotypes on MS and on the risk for type 2 diabetes mellitus (T2DM). Methods: This was an observational study of 457 PCOS women, whose demographic, clinical, hormonal, and metabolic data underwent analysis. The PCOS women were divided into four groups per NIH recommendations. Results: After a follow-up of a mean of six years (1–20 years), 310 patients were selected to assess the development of T2DM and MS. The clinical and biochemical parameters, along with the Rotterdam phenotypes, were evaluated. Data were analyzed using Student’s t- and the Pearson chi-square tests for data variation and group proportions, respectively. Additionally, multivariate analysis was applied to evaluate the effect of PCOS phenotypes on the risk for MS and T2DM. Patients of the four PCOS phenotypes did not differ in age, body mass index, total testosterone, insulin resistance, and dyslipidemia, but phenotype A patients showed the highest risk for T2DM. A decrease in androgen levels was not followed by an improved metabolic profile; instead, there was a significant increase in the number of T2DM cases. Conclusion: Phenotype A women are at the highest risk for type 2 diabetes mellitus.

Current work provides an algebraic and geometric technique for building topological quantum codes. From the lattice partition derived of quotient lattices Λ ′ / Λ of index m combined with geometric technique of the projections of vector basis Λ ′ over vector basis Λ , we reproduce surface codes found in the literature with parameter [ [ 2 m , 2 , | a | + | b | ] ] for the case Λ = Z 2 and m = a 2 + b 2 , where a and b are integers that are not null, simultaneously. We also obtain a new class of surface code with parameters [ [ 2 m , 2 , | a | + | b | ] ] from the Λ = A 2 -lattice when m can be expressed as m = a 2 + a b + b 2 , where a and b are integer values. Finally, we will show how this technique can be extended to the construction of color codes with parameters [ [ 18 m , 4 , 6 (| a | + | b |) ] ] by considering honeycomb lattices partition A 2 / Λ ′ of index m = 9 (a 2 + a b + b 2) where a and b are not null integers. [ABSTRACT FROM AUTHOR]

This study delves into the effectiveness of two time integration techniques, namely the adaptive implicit–explicit (imp–exp) and explicit–explicit (exp–exp) methods, which stand as efficient formulations for tackling intricate systems characterized by multiple time scales. The imp–exp technique combines implicit and explicit procedures by employing implicit formulations for faster components and explicit calculations for slower ones, achieving high accuracy and computational efficiency. Conversely, the exp–exp method, a variation of explicit methods with sub-cycling, excels in handling locally stiff systems by employing smaller sub-steps to resolve rapid changes while maintaining stability. For both these approaches, numerical damping may be activated by adaptive time integration parameters, allowing numerical dissipation to be locally applied, if necessary, as a function of the considered discrete model and its computed responses, enabling a highly effective numerical dissipative algorithm. Furthermore, both these techniques stand as very simple and straightforward formulations as they rely solely on single-step displacement–velocity relations, describing truly self-starting procedures, and they stand as entirely automated methodologies, requiring no effort nor expertise from the user. This work provides comparative studies of the adaptive imp–exp and exp–exp approaches to assess their accuracy and efficiency across a wide range of scenarios, with emphasis on geophysical applications characterized by multiscale problems, aiming to establish under which circumstances one approach should be preferred over the other. [ABSTRACT FROM AUTHOR]