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Background: The caterpillar of Premolis semirufa, known as Pararama, is found in the Brazilian Amazon, primarily on rubber trees of the genus Hevea. Pararamosis is an inflammatory disease resulting from accidental contact with the caterpillar's bristles, leading to acute and chronic symptoms. Chronic exposure can cause significant osteoarticular deformities, similar to those seen in osteoarthritis and rheumatoid arthritis, due to cartilage degradation and synovial inflammation. Currently, there are no specific treatments for Pararamosis, and research on the molecular mechanisms of the caterpillar's venom and its role in disease pathogenesis is limited. The chronic changes in Pararamosis are thought to be linked to chondrocyte activation and the NF-κB signaling pathway, influenced by the toxic components in the bristles. Understanding these interactions is crucial for developing preventive measures and therapeutic strategies, especially for rubber tappers at risk in the Amazon region., Methodology/principal Findings: This study investigated the effects of P. semirufa bristle extracts on human chondrocytes, focusing on the activation mechanism of the NF-κB transcription factor and the expression of osteoarthritis markers. Cell viability tests indicated that the extracts did not significantly affect chondrocyte survival. However, supernatant analysis revealed a time- and dose-dependent increase in IL-6 and IL-8 levels. Additionally, the expression of NF-κB and its inhibitor, IκB, was assessed, showing higher levels of phosphorylated IκB, which induces its proteosomal degradation, compared to the negative control, while native IκB expression was greater in the control group. Furthermore, the gene expression profile of treated chondrocytes demonstrated modulation in matrix metalloproteinases (MMPs), aggrecan (ACAN), collagen type II (COL2A1), interleukins (IL6 and IL8), and complement system molecules., Conclusions/significance: These findings highlight the significant impact of P. semirufa bristle extracts on human chondrocyte activation and the inflammatory processes associated with pararamosis., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 de Lima 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.)

This study aimed to identify immunodominant molecules with potential for S. stercoralis infection immunodiagnosis. Serum samples were tested by an IgG-ELISA using Strongyloides venezuelensis soluble (AgS) and membrane (AgM) antigens, and its protein fractions (<100 and >100 kDa). Proteins were tested by one- and two-dimensional (2D) gel immunoblotting. The ELISA results showed sensitivities, ranging from 82.3 to 85.3 %, while specificities ranged from 60.0 to 93.3 %. Cross-reactivities were observed with sera from individuals infected with other helminths. Immunoreactive protein bands were revealed by Western blotting using both antigens, and a band with molecular weight around 140 kDa of AgS showed 100 % sensitivity and specificity, without cross-reactivity. The 2D immunoblotting revealed 7 spots in the 140 kDa protein with the S. stercoralis pool of serums. The pre-selection of Strongyloides immunodominant proteins that are highly specific and free from cross-reactions is essential for the production of recombinant antigens for the immunodiagnosis of strongyloidiasis., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Cintia de Lima Oliveira reports financial support, administrative support, statistical analysis, and writing assistance were provided by Foundation for Research Support of Bahia State. If there are other authors, they 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. Published by Elsevier Inc.)

This systematic review of clinical studies investigated whether circulating PRL levels differed between subjects with systemic lupus erythematosus (SLE) and healthy controls, the correlation between circulating PRL and SLE activity, and the effect of dopaminergic agonists as adjuvant therapy for SLE. We searched PubMed, Scopus, Web of Science, Cochrane, Embase, and Google Scholar for case-control and cross-sectional studies investigating circulating PRL levels in subjects with SLE and/or its correlation with disease activity, and clinical trials examining the effect of dopaminergic agonists on SLE activity assessed by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. Forty-five studies addressing circulating PRL levels in SLE met our inclusion criteria. SLE was associated with an increased odds of hyperprolactinemia (OR 11.69, 95%CI 5.64-24.22) and circulating PRL levels were significantly higher in subjects with SLE than in controls (standardized mean difference of 1.62, 95%CI 1.14-2.09). Circulating PRL was positively correlated with SLE activity assessed by the SLEDAI (correlation coefficient 0.38, 95% CI 0.26-0.48). Two randomized clinical trials with bromocriptine and three prospective open-label trials with quinagolide reported that treatment with dopaminergic agonists was associated with reduced frequency of disease flares and decreased SLEDAI score. Circulating PRL levels were higher in subjects with SLE than in healthy controls and were significantly associated with disease activity. In addition, treatment with the dopaminergic agonists bromocriptine and quinagolide reduced SLE disease activity in small studies and may be a beneficial adjuvant therapy for the disease if larger trials confirm these findings. This review was registered in PROSPERO (CRD42021237156)., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Empirical data on decomposition ecology have long established blowflies (Calliphoridae) and flesh flies (Sarcophagidae) (Diptera) as the most frequent colonizers of carrion, especially at early stages of decomposition. However, the scarcity of studies based on human cadavers has hindered inferences about colonization of homicide victims in real case scenarios. We describe here a survey of insects associated with cadavers retrieved from the site of death in Northeastern Brazil, with emphasis on the association between species diversity and the surrounding environment. We examined 81 cadavers, most of which were of men and resulting from violent death. Twelve cadavers (14.8 %) contained insect larvae, which were reared in the laboratory until adult emergence and identification. Ten species of Diptera effectively colonized the cadavers; seven of Family Calliphoridae - Chrysomya albiceps (Wiedemann, 1819), Chrysomya megacephala (Fabricius, 1794), Chrysomya putoria (Wiedemann, 1830), Cochliomyia macellaria (Fabricius, 1775), Hemilucilia segmentaria (Fabricius, 1805), Lucilia cuprina (Wiedemann, 1830), Lucilia eximia (Wiedemann, 1819) and three of Family Sarcophagidae, Blaesoxipha (Gigantotheca) stallengi (Lahille, 1907), Microcerella halli (Engel, 1931) and Peckia (Sarcodexia) lambens (Wiedemann, 1830). The species C. albiceps and C. macellaria were the most frequent colonizers, while Sarcophagidae was reported in only four cases. Insects were present on cadavers found in urban (n = 8) and rural (n = 4) sites, outdoors (n = 6) and inside (n = 6) residences. Presence of larvae was more frequent in the natural orifices in the head (n = 11). Clothing did not prevent from ovi/larviposition for most species. We present the first register of B. stallengi colonizing human corpses and expand the knowledge on the geographical distribution of necrophagous insects. Our protocol may contribute to forensic entomology in areas exposed to fast decomposition, such as the Neotropical Region., 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.)

Objective: To assess whether post-discharge telemonitoring reduces hospital readmission in patients participating in the diabetes care program., Methods: This retrospective cohort study was conducted from June 2021 to December 2022 and included patients who were enrolled in the Diabetes Program under a hyperglycemia treatment protocol and eligible for post-discharge telemonitoring. The variables included age, sex, diagnosis, hospital stay, LACE Score, and readmission rate., Results: Among 165 patients who underwent telemonitoring, significant differences emerged in hospital readmission rates between those with and without telemonitoring (p=0.015), with a 15.4% lower readmission rate in the telemonitoring group (95%CI= 3.0-27.9%). Subgroup analyses revealed higher readmission rates in men without telemonitoring (15.2% difference; 95%CI= 0.4-30.0%; p=0.045), and in age groups ≤60 and ≥75 years without telemonitoring (24.2% difference; 95%CI= 4.5-43.9%; p=0.016 for ≤60 years; 37.1% difference; 95%CI= 9.9% to 64.2%; p=0.007 for ≥75 years). Additionally, patients with prolonged hospital stays (>7 days) without telemonitoring had higher readmission rates (19.5% difference; 95%CI= 4.5%-34.5%; p=0.011)., Conclusion: This study suggests that post-discharge telemonitoring can effectively lower hospital readmission rates in diabetes management programs, potentially offering improved health outcomes, cost savings, and enhanced healthcare delivery to patients.

Introduction: Chickens with Necrotic Enteritis (NE), caused by Clostridium perfringens, exhibit acute and chronic symptoms that are difficult to diagnose, leading to significant economic losses. Vaccination is the best method for controlling and preventing NE. However, only two vaccines based on the CPA and NetB toxins have been commercialized, offering partial protection, highlighting the urgent need for more effective vaccines., Objective: This review aimed to identify promising antigens for NE vaccine formulation and discuss factors affecting their effectiveness., Methods: A systematic review using five scientific databases identified 30 eligible studies through the Rayyan tool, which were included for quality review., Results: We identified 25 promising antigens, including CPA, NetB, FBA, ZMP, CnaA, FimA, and FimB, categorized by their role in disease pathogenesis. This review discusses the biochemical, physiological, and genetic traits of recombinant antigens used in vaccine prototypes, their expression systems, and immunization potential in chickens challenged with virulent C. perfringens strains. Market supply challenges, immunogenic potential, vaccine platforms, adjuvants, and factors related to vaccination schedules-such as administration routes, dosing intervals, and age at immunization-are also addressed. Additionally, the study notes that vaccine formulations tested under mild challenges may not offer adequate field-level protection due to issues replicating aggressive conditions, strain virulence loss, and varied methodologies., Conclusions: An ideal NE vaccine should incorporate multiple antigens, molecular adjuvants, and delivery systems via in ovo and oral routes. The review underscores the challenges in developing and validating NE vaccines and the urgent need for a standardized protocol to replicate aggressive challenges accurately., 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.)

Epidemiological and experimental studies have demonstrated that combined exposure to the pesticides paraquat (PQ) and maneb (MB) increases the risk of developing Parkinson's disease. However, the mechanisms mediating the toxicity induced by combined exposure to these pesticides are not well understood. The aim of this study was to investigate the mechanism(s) of neurotoxicity induced by exposure to the pesticides PQ and MB isolated or in association (PQ + MB) in SH-SY5Y neuroblastoma cells. PQ + MB exposure for 24 and 48 h decreased cell viability and disrupted cell membrane integrity. In addition, PQ + MB exposure for 12 h decreased the mitochondrial membrane potential. PQ alone increased reactive oxygen species (ROS) and superoxide anion generation and decreased the activity of mitochondrial complexes I and II at 12 h of exposure. MB alone increased ROS generation and depleted intracellular glutathione (GSH) within 6 h of exposure. In contrast, MB exposure for 12 h increased the GSH levels, the glutamate cysteine ligase (GCL, the rate-limiting enzyme in the GSH synthesis pathway) activity, and increased nuclear Nrf2 staining. Pretreatment with buthionine sulfoximine (BSO, a GCL inhibitor) abolished the MB-mediated GSH increase, indicating that MB increases GSH synthesis by upregulating GCL, probably by the activation of the Nrf2/ARE pathway. BSO pretreatment, which did not modify cell viability per se, rendered cells more sensitive to MB-induced toxicity. In contrast, treatment with the antioxidant N -acetylcysteine protected cells from MB-induced toxicity. These findings show that the combined exposure of SH-SY5Y cells to PQ and MB induced a cytotoxic effect higher than that observed when cells were subjected to individual exposures. Such a higher effect seems to be related to additive toxic events resulting from PQ and MB exposures. Thus, our study contributes to a better understanding of the toxicity of PQ and MB in combined exposures.

The cocoa tree ( Theobroma cacao L.) has seeds that after processing become a valuable agricultural commodity in the world. In Brazil, the state of Pará located in the Eastern Amazon is the main producer, accounting for more than 53% of the national production. Although the region is the largest producer, no studies are found in the literature containing data on the sensory quality of the beans. Thus, the purpose of this study is to establish the sensory profile of Amazonian cocoa from the main cocoa-producing regions of the Eastern Amazon (Lower Tocantins River, Northeast, West, Southeast and Trans-Amazon). The sensory profile was established from the Quantitative Descriptive Analysis (QDA), in addition to using an affective test to verify consumer preference for the chocolates produced. Physical, physicochemical and bioactive compound evaluations were carried out. Beans from different regions had a similar sensory profile; however, it was possible to observe some differences in certain descriptor terms. In the physical evaluation, the samples presented an acceptable commercial standard, and the humidity was within the values established by the legislation. It was found that the post-harvest and/or processing parameters had no influence on the quality attributes of cocoa beans.

Background: Twenty years after the "To Err Is Human" report, one in ten patients still suffer harm in hospitals in high-income countries, highlighting the need to strengthen the culture of safety in healthcare. This scoping review aims to map patient safety culture strengthening strategies described in the literature., Method: This scoping review follows the JBI methodology. It adhered to all scoping review checklist items (PRISMA-ScR) with searches in the Lilacs, MedLine, IBECS, and PubMed databases and on the official websites of Brazilian and North American patient safety organizations. The research took place during the year 2023., Results: In total, 58 studies comprising 52 articles and 6 documents from health organizations were included. Various strategies were identified and grouped into seven categories based on similarity, highlighting the need for a comprehensive organizational approach to improve patient care. The most described strategies were communication (69%), followed by teamwork (58.6%) and active leadership (56.9%)., Conclusion: The identified strategies can promote the development of a culture in which an organization can achieve patient safety, involving practices and attitudes that reduce risks and errors in healthcare. However, the identification of strategies is limited because it is restricted to certain databases and websites of international organizations and does not cover a broader spectrum of sources. Furthermore, the effectiveness of these strategies in improving patient safety culture has not yet been evaluated.

In this commentary on the J-AIM Special Issue 'Integrative Approaches to Health', we argue for plural narratives of health to balance and to reconnect human populations with their environments, to foster a renewed culture of health and wellbeing. Integration of our inner and outer ecosystems with pluralistic health systems requires 'movement' and 'change' and the special issue provides papers on integration and health from multiple disciplinary perspectives that study humans, non-human, animals, and plants in relation to clinical trials, individual and population studies and health systems. All these perspectives provide new insights to map integrative approaches in health, illness and wellbeing in times of the climate emergency. To ameliorate the biomedical and biopharmaceutical industries 'medicalisation of life' as the hegemonic and thus totalising human and more-than-human health systems and approach, the special issue acknowledges, situates and authorises broader visions and epistemologies of health and disease. These complementary epistemologies, their words, their movements (Ayu) and their health (Swastya) and balance (Soukya) are contained within indigenous health systems that include Ayurveda and Traditional Chinese Medicine (TCM) amongst a vast array of local health cultures across the globe. In contrast with the narrower approach of medicalisation; integrative, inclusive, plural and sustainable approaches to health involve the respect for a population's self-reliance in health (the 4 th Tier) and the dignity of the Sanskrit word for health, 'Swastya' which means 'being rooted within'. These perspective and epistemologies will help to create a vision for health and health systems that encourage integration through the dignity of the individual (Atmasnman/Anubhuti), respect for the other (Pratiksa/Adara), trust in community (Nyasa) and the creation of systems of equity (Samata) and social justice for all (Nyaya)., Competing Interests: Conflict of Interest The authors declare that there is no conflict of interests regarding the publication of this paper. Though first and last author has been working with J-AIM as guest editor for this special issue on integration. Although MMM and JP were a part of JAIM editorial team they were not included in the review and editing of this article., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Raine syndrome (RNS) is a rare autosomal recessive osteosclerotic dysplasia. RNS is caused by loss-of-function disease-causative variants of the FAM20C gene that encodes a kinase that phosphorylates most of the secreted proteins found in the body fluids and extracellular matrix. The most common RNS clinical features are generalized osteosclerosis, facial dysmorphism, intracerebral calcifications and respiratory defects. In non-lethal RNS forms, oral traits include a well-studied hypoplastic amelogenesis imperfecta (AI) and a much less characterized gingival phenotype. We used immunomorphological, biochemical, and siRNA approaches to analyze gingival tissues and primary cultures of gingival fibroblasts of two unrelated, previously reported RNS patients. We showed that fibrosis, pathological gingival calcifications and increased expression of various profibrotic and pro-osteogenic proteins such as POSTN, SPARC and VIM were common findings. Proteomic analysis of differentially expressed proteins demonstrated that proteins involved in extracellular matrix (ECM) regulation and related to the TGFβ/SMAD signaling pathway were increased. Functional analyses confirmed the upregulation of TGFβ/SMAD signaling and subsequently uncovered the involvement of two closely related transcription cofactors important in fibrogenesis, Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ). Knocking down of FAM20C confirmed the TGFβ-YAP/TAZ interplay indicating that a profibrotic loop enabled gingival fibrosis in RNS patients. In summary, our in vivo and in vitro data provide a detailed description of the RNS gingival phenotype. They show that gingival fibrosis and calcifications are associated with, and most likely caused by excessed ECM production and disorganization. They furthermore uncover the contribution of increased TGFβ-YAP/TAZ signaling in the pathogenesis of the gingival fibrosis., (© 2024. The Author(s).)

Introduction: Asthma is a condition of airflow limitation, common throughout the world, with high mortality rates, especially as it still faces some obstacles in its management. As it constitutes a public health challenge, this study aimed to investigate the effect of copaiba oil (e.g., Copaifera langsdorffii ), as a treatment resource, at doses of 50 and 100 mg/kg on certain mediators of acute lung inflammation (IL-33, GATA3, FOXP3, STAT3, and TBET) and early mechanisms of lung remodeling (degradation of elastic fiber tissues, collagen deposition, and goblet cell hyperplasia). Methods: Using an ovalbumin-induced acute allergic asthma model in BALB/c mice, we analyzed the inflammatory mediators through immunohistochemistry and the mechanisms of lung remodeling through histopathology, employing orcein, Masson's trichrome, and periodic acid-Schiff staining. Results: Copaiba oil treatment (CO) reduced IL-33 and increased FOXP3 by stimulating the FOXP3/GATA3 and FOXP3/STAT3 pathways. Additionally, it upregulated TBET, suggesting an additional role in controlling GATA3 activity. In the respiratory epithelium, CO decreased the fragmentation of elastic fibers while increasing the deposition of collagen fibers, favoring epithelial restructuring. Simultaneously, CO reduced goblet cell hyperplasia. Discussion: Although additional research is warranted, the demonstrated anti-inflammatory and re-epithelializing action makes CO a viable option in exploring new treatments for acute allergic asthma., 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 Caputo, Alves, Laranjeira, Fonseca-Rodrigues, da Silva Filho, Dias, Pinto-Ribeiro, Pereira Junior, de Paula, Nagato and Corrêa.)

Sesame, an oilseed plant with multiple applications, is susceptible to infestations by the stink bug Nezara viridula (Linnaeus, 1758) (Hemiptera: Pentatomidae). This pest suctions the seeds of this plant and injects toxins into them. Possible sources of resistance on sesame cultivars are important to manage this bug. The objective of this study was to evaluate the biological aspects of N. viridula fed on three sesame cultivars aiming to select possible resistance sources for integrated pest management (IPM) programs of this stinkbug. The experimental design used randomized blocks with three treatments and four replications, each with newly emerged N. viridula nymphs fed with sesame capsules of the cultivars BRS Anahí (T1), BRS Morena (T2) and BRS Seda (T3). Two to three green sesame capsules were supplied every two days per group of ten N. viridula nymphs as one replication until the beginning of the adult stage. Adults of this stinkbug were fed in the same manner as its nymphs but with mature sesame capsules until the end of the observations. Survival during each of the five instars and of the nymph stage of N. viridula with green sesame capsules was similar between cultivars, but the duration of the nymph stage was shorter with green capsules of the BRS Morena than with those of the BRS Anahí. The oviposition period, number of egg masses and eggs per female, and the percentage of nymphs hatched were higher with mature capsules of the sesame cultivar BRS Anahí and lower with the others. Nymphs did not hatch from eggs deposited by females fed mature seed capsules of the sesame cultivar BRS Morena, which may indicate a source of resistance against this stinkbug in this cultivar. The worldwide importance of N. viridula to sesame cultivation makes these results useful for breeding programs of this plant aiming to develop genotypes resistant to this bug. In addition, the BRS Morena is a cultivar already commercially available and can be recommended in places where there is a history of incidence of N. viridula , aiming to manage the populations of this pest.

The high incidence of multidrug-resistant (MDR) Acinetobacter baumannii has been a challenge for health worldwide, due to the reduction of therapeutic options, making the use of antimicrobial combinations necessary for the treatment, such as meropenem, amikacin, and colistin. Antibodies against bacterial species, mainly immunoglobulins G (IgG), are produced for acting as effector mechanisms (neutralization, opsonization, phagocytosis, and complement system activation). Some studies have demonstrated promising results of IgG in combination with antimicrobial preparations against bacterial infections, in which the direct action of IgG has restored the immune system balance. Serious problem caused by the increase of MDR A. baumannii isolates results in a constant search for therapeutic alternatives to defeat these infections. However, this study aims to verify in vitro the phagocytosis rate of the A. baumannii-infected human monocytes, as well as to analyze possible morphological changes induced by intravenous immunoglobulin G (IVIG) with human serum in association with antimicrobials. The phagocytosis rate and bacterial cell binding capacity of IVIG were determined for two A. baumannii isolates submitted to 4 mg/mL of human IVIG alone and in combination with different sub-minimum inhibitory concentrations (sub-MICs) of meropenem, amikacin, and colistin and processed for indirect immunofluorescence. Subsequently, these isolates were resubmitted and coupled with human serum and processed for scanning electron microscopy. There was no statistical difference for phagocytosis rates in the isolates tested. Bacterial isolates showed alterations in cell morphology when exposed to IVIG/human serum alone and in combination with antimicrobials such as alteration in shape, wrinkling, membrane depression, and especially cell rupture with extravasation of cytoplasmic material. The isolates visually differed in the IVIG binding to the bacterial cell, with higher fluorescence intensity, which corresponds to the highest IVIG binding, in the isolate more sensitive to meropenem, amikacin, and colistin. No differences between treatments were observed in the IVIG binding to the bacterial cell. The combined action of IVIG with meropenem, amikacin, and colistin against A. baumannii MDR isolates induced several bacterial cell damages. And when associated with human serum, a massive destruction of cells can be observed. These results may suggest the analysis of the use of IgG preparations for the treatment of A. baumannii MDR infections., (© 2023. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

Introduction: Extracellular vesicles (EVs) have been implicated in the spread of neuropathology in Alzheimer's disease (AD), but their involvement in behavioral outcomes linked to AD remains to be determined., Methods: EVs isolated from post mortem brain tissue from control, AD, or frontotemporal dementia (FTD) donors, as well as from APP/PS1 mice, were injected into the hippocampi of wild-type (WT) or a humanized Tau mouse model (hTau/mTauKO). Memory tests were carried out. Differentially expressed proteins in EVs were assessed by proteomics., Results: Both AD-EVs and APP/PS1-EVs trigger memory impairment in WT mice. We further demonstrate that AD-EVs and FTD-EVs carry Tau protein, present altered protein composition associated with synapse regulation and transmission, and trigger memory impairment in hTau/mTauKO mice., Discussion: Results demonstrate that AD-EVs and FTD-EVs have negative impacts on memory in mice and suggest that, in addition to spreading pathology, EVs may contribute to memory impairment in AD and FTD., Highlights: Aβ was detected in EVs from post mortem AD brain tissue and APP/PS1 mice. Tau was enriched in EVs from post mortem AD, PSP and FTD brain tissue. AD-derived EVs and APP/PS1-EVs induce cognitive impairment in wild-type (WT) mice. AD- and FTD-derived EVs induce cognitive impairment in humanized Tau mice. Proteomics findings associate EVs with synapse dysregulation in tauopathies., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Enteroparasites are an important public health problem and the treatment seeks to cure and reduce transmission. The aim of this study was to evaluate the therapeutic efficacy of anthelmintic treatment in individuals living in a rural community area in Camamu, Bahia, Brazil. The parasitological diagnosis was performed by spontaneous sedimentation, Baermann-Moraes and Agar Plate Culture methods. A total of 212 individuals were evaluated. The most frequent helminth was Trichuris trichiura, 24.5% (52/212), followed by Ascaris lumbricoides, 21.2% (45/212), hookworms, 16.5% (35/212), and S. stercoralis, 4.7% (10/212). In the anthelmintic treatment follow up, T. trichiura infection presented the lowest parasitological cure rate, only 60.6% (20/33). Hookworm, Ascaris lumbricoides and Strongyloides stercoralis infections demonstrated cure rates of 70.5 (12/17), 78.1 (25/32) and 100% (5/5), respectively. Individuals who remained infected underwent a new drug therapy. The second parasitological cure rate for T. trichiura was 38.5% (5/13), and 66.7% (2/3) and 75% (3/4) for hookworms and Ascaris lumbricoides, respectively. Trichuris trichiura infection presented the lowest parasitological cure rate at this second evaluation. This reinforces the need to perform a follow-up of all treated individuals. The possibility of drug resistance denotes the necessity for studies to clarify the mechanisms and to evaluate new therapeutic approaches.

Background: Myocardial bridges (MB) are anatomical anomalies with possible clinical repercussions; hence, their understanding deserves attention., Objective: To determinate the prevalence and characterize MB in human hearts from the state of Ceará. Methods: Fifty hearts of adult human cadavers from the Medicine School of Federal University of Ceará, Brazil. The hearts were dissected to identify MBs that pass over part of the coronary artery. The segment of the artery (proximal, middle, and distal) with a bridge was identified. The external diameter of the artery at the proximal and distal points of the MB was measured. The length and thickness of the MB were also measured with an electronic caliper. The muscle index (MMI) of the MB was calculated as the product of length and thickness expressed in millimeters. The significance level adopted in the statistical analysis was 5%., Results: MB was confirmed in 40% of sample. Approximately one third of the sample had only 1 MB. MB was most frequently found over the anterior interventricular branch of the left coronary artery (59.25%, p=0.02), and its prevalence in other branches was much lower (22.23%). The most affected segments of arteries were the superior (44.44%) and medium (40.74%). The mean diameter of arteries proximal to the MB was 2.38±0.97mm (range=0.78-5.15mm), and the diameter distal to the MB was 1.71±0.75mm (range=0.42-3.58mm). The length was measured as mean=8.55±5.27mm, while the mean thickness was 0.89±0.33mm., Conclusion: A high prevalence of MB is more likely to affect the left coronary artery system with larger MMI than other affected branches.

Strongyloidiasis control is associated with a Th2 immune response. However, alcohol ingestion plays an important role in modulating the immune system. The aim of this study is to evaluate the occurrence of Strongyloides stercoralis infection in alcoholic patients, the levels of circulating cytokines (IFN-γ, IL-2, IL-4, IL-5, IL-10, IL-15 and IL-17), and its correlation with modulation of parasitic load in alcoholic individuals infected with S. stercoralis. A total of 336 alcoholic patients, treated at the Alcoholic Care and Treatment Center were included in this study. The cytokine levels were measured by a commercial ELISA in 80 sera divided into four groups with 20 individuals each: alcoholics infected (ASs+) and not infected (ASs-) with S. stercoralis and non-alcoholics infected (NASs+) and not infected (NASs-) with the helminth. S. stercoralis frequency in alcoholic patients was 16.1% (54/336). The parasitic load varied from 1 to 546 larvae/g of faeces, median and interquartile range (IQR) of 9 and 1.0-62.5 larvae/g of faeces, while in non-alcoholic individuals the parasitic load was less than 10 larvae/g of faeces. Levels of circulating IL-4 were significantly higher in ASs+ when compared with NASs- group (p < .05). An inverse correlation between serum levels of IFN-γ and parasitic load in alcoholic patients infected with S. stercoralis was observed (r = -601; p < 0.01). These results suggest that modulation of IFN-γ production occurs in alcoholic individuals with high parasitic burden., (© 2023 John Wiley & Sons Ltd.)

In December 2019, the spread of the SARS-CoV-2 virus to the world gave rise to probably the biggest public health problem in the world: the COVID-19 pandemic. Initially seen only as a disease of the respiratory system, COVID-19 is actually a blood disease with effects on the respiratory tract. Considering its influence on hematological parameters, how does COVID-19 affect cardiac function? Is it possible to support the clinical diagnosis of COVID-19 from the automatic analysis of electrocardiography? In this work, we sought to investigate how COVID-19 affects cardiac function using a machine learning approach to analyze electrocardiography (ECG) signals. We used a public database of ECG signals expressed as photographs of printed signals, obtained in the context of emergency care. This database has signals associated with abnormal heartbeat, myocardial infarction, history of myocardial infarction, COVID-19, and healthy heartbeat. We propose a system to support the diagnosis of COVID-19 based on hybrid deep architectures composed of pre-trained convolutional neural networks for feature extraction and Random Forests for classification. We investigated the LeNet, ResNet, and VGG16 networks. The best results were obtained with the VGG16 and Random Forest network with 100 trees, with attribute selection using particle swarm optimization. The instance size has been reduced from 4096 to 773 attributes. In the validation step, we obtained an accuracy of 94%, kappa index of 0.91, and sensitivity, specificity, and area under the ROC curve of 100%. This work showed that the influence of COVID-19 on cardiac function is quite considerable: COVID-19 did not present confusion with any heart disease, nor with signs of healthy individuals. It is also possible to build a solution to support the clinical diagnosis of COVID-19 in the context of emergency care from a non-invasive and technologically scalable solution, based on hybrid deep learning architectures., (© 2023. International Federation for Medical and Biological Engineering.)

Objectives: This systematic review and meta-analysis aimed to address whether non-surgical periodontal therapy (NSPT) can affect insulin resistance, estimated by the homeostasis model assessment (HOMA), in adults with prediabetes or type 2 diabetes mellitus and periodontitis., Materials and Methods: Six electronic databases and the gray literature were systematically searched for interventional studies reporting NSPT effect on insulin resistance. Seven studies met the eligibility criteria to be synthesized in the qualitative analysis, six reporting change in HOMA-IR, three reporting change in HOMA-%S, and two in HOMA-β. Among them, four were pooled in a meta-analysis of standardized mean difference (SMD) of HOMA-IR; comparing pre- and post-intervention values, three were pooled considering HOMA-%S as outcome, and two studies were summarized considering SMD of HOMA-%S between intervention and control groups. HOMA-β results were qualitatively synthetized., Results: With low level of certainty, NSPT significantly reduced HOMA-IR, when compared with pre-intervention data (SMD, -0.35, 95% CI -0.63 to 0.07, p=0.02). There were no significant changes in HOMA-%S or in HOMA-β scores. The level of certainty was very low and moderate, respectively., Conclusions: Assertions about a causal link between NSPT and insulin resistance are weak and conflicting, although our more robust results point out to the absence of effect. ., Clinical Relevance: Because further high-quality studies assessing the relationship between periodontitis and insulin resistance are need, the findings of the current systematic review are limited to give recommendations for clinicians. However, while identifying a lack of research in humans with T2D concerning periodontitis and insulin resistance, this study reinforces the need of multicenter well-designed randomized clinical trials., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aedes (Stegomyia) albopictus (Skuse, 1854) was reported in Brazil for the first time in 1986 and has shown marked expansion throughout the Brazilian territory. During a routine activity to control dengue fever conducted by the Division of Entomology of the Municipal Health Department in Rio Branco city, adults and immatures of Culicidae were collected in a peri-urban area. The identified Culicidae forms indicated that they belonged to the species Ae. albopictus. This is the first official record of the presence of Ae. albopictus in the Acre State, confirming its current presence in all Brazilian states.

The dramatic increase in the number of COVID-19 cases has been a threat to global health and a challenge for health systems. Estimating the prevalence of infection in the population is essential to provide support for action planning. Within this scenario, the aim of the present study was to analyze the seroprevalence and associated factors of COVID-19 Jundiaí, São Paulo, Brazil. This cross-sectional study was conducted from June 1st to June 19th, 2020. The participants were patients with respiratory symptoms who sought Primary Care Units (UBS) (n = 1,181) and subjects recruited from randomly selected households by probability sampling (n = 3,065), as screening strategy. All participants, in both phases, were submitted to SARS-CoV-2 rapid antigen tests (IgG and IgM) and responded to a questionnaire including sociodemographic characteristics based on Behavioural Insights for COVID-19. Total seroprevalence (positive/negative) was the outcome and the independent variables were sociodemographic variables, health behavior and signs/symptoms. The chi-squared test was used for association analysis (p<0.05) and variables with p<0.20 were entered into the logistic regression model (p<0.05). A total of 1,181 subjects from the UBS and 3,065 from the selected households participated in the study. The seroprevalence was 30.8% in the UBS and 3.1% in the households. The adjusted logistic regression identified that lower educational level (OR 2.68; 95%CI 1.59-4.54), household member testing positive (OR 1.67; 95%CI 1.16-2.39), presence of anosmia (OR 3.68, 95%CI 2.56-5.28) and seeking UBS (OR 3.76; 95%CI 2.08-6.82) was risk factors to test positive for SARS-CoV-2. Estimating the seroprevalence in the population was important to know the disease extension that was higher than the notified cases. These results showed socioeconomic aspects associated with COVID-19 even adjusted by symptoms. Populational epidemiologic studies that investigate the associated factors of COVID-19 are relevant to plan strategies to control the pandemic., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Batista 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.)

Arboviruses are a group of diseases that are transmitted by an arthropod vector. Since they are part of the Neglected Tropical Diseases that pose several public health challenges for countries around the world. The arboviruses' dynamics are governed by a combination of climatic, environmental, and human mobility factors. Arboviruses prediction models can be a support tool for decision-making by public health agents. In this study, we propose a systematic literature review to identify arboviruses prediction models, as well as models for their transmitter vector dynamics. To carry out this review, we searched reputable scientific bases such as IEE Xplore, PubMed, Science Direct, Springer Link, and Scopus. We search for studies published between the years 2015 and 2020, using a search string. A total of 429 articles were returned, however, after filtering by exclusion and inclusion criteria, 139 were included. Through this systematic review, it was possible to identify the challenges present in the construction of arboviruses prediction models, as well as the existing gap in the construction of spatiotemporal models., 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 © 2022 Lima, da Silva, Moreno, Cordeiro da Silva, Musah, Aldosery, Dutra, Ambrizzi, Borges, Tunali, Basibuyuk, Yenigün, Massoni, Browning, Jones, Campos, Kostkova, Silva Filho and dos Santos.)

Purpose: S. stercoralis diagnosis is currently performed by parasitological methods, mainly by Baermann-Moraes (BM), although Agar Plate Culture (APC) presents a higher sensitivity. New techniques, such as TF-Test® and Coproplus® have been suggested as more practical alternatives. The aim of this study was to evaluate the sensitivity of TF-Test® and Coproplus®, compared with APC, BM and Spontaneous Sedimentation (SS) methods., Methods: One-hundred and forty male alcoholic patients, who provided three stools samples collected on alternate days, were included in this study. The most frequently found parasite was S. stercoralis, 20% (28/140), and the most sensitive method was APC, 96.4% (27/28), followed by BM, 89.3% (25/28) and SS, 57.1% (16/28). TF-Test® and Coproplus® presented a sensitivity of 46.4 (13/28) and 39.3% (11/28), respectively. In samples with a parasitic load of 1-10 larvae/g of feces, which occurred in 39.3% (11/28) of the infected patients, both the TF-Test® and Coproplus® methods demonstrated sensitivities of 18.2% (2/11), while APC and BM methods reached a sensitivity of 100% (11/11) (p < 0.05). For other intestinal helminth infections, TF-Test® and Coproplus® sensitivities were 22.2 (4/18) and 11.1% (2/18), respectively, this being lower than the SS, 66.7% (12/18) (p < 0.05). On the other hand, for protozoa infection diagnosis, TF-Test® and Coproplus® presented the highest sensitivities, 62.2 (46/74) and 43.2% (32/74), respectively., Conclusion: TF-Test® and Coproplus® methods presented the lowest sensitivities for S. stercoralis and other helminth infection diagnosis; therefore, they can be indicated for use in parasitological diagnosis, only when associated with other more effective methods of helminth identification., (© 2021. The Author(s) under exclusive licence to Witold Stefański Institute of Parasitology, Polish Academy of Sciences.)

Introduction: Individuals infected with the human T-lymphotropic virus type 1 (HTLV-1) may present severe and disseminated forms of Strongyloides stercoralis infection with low therapeutic response., Objective: To investigate the S. stercoralis infection and the seroprevalence of IgG anti-S. stercoralis antibodies in individuals infected with HTLV-1 attending the Reference Center for HTLV-1 (CHTLV) in Salvador, Bahia, Brazil., Materials and Methods: We conducted a cross-sectional study in 178 HTLV-1-infected individuals treated at the HTLV specialized center between January, 2014, and December, 2018. The parasitological diagnosis of S. stercoralis was performed using the Hoffman, Pons and Janer, agar plate culture, and Baermann-Morais methods. The IgG anti-S. stercoralis detection was performed using an in house enzyme-linked immunosorbent assay (ELISA). The HTLV-1 infection was diagnosed using a commercial ELISA and confirmed by Western blot., Results: The frequency of S. stercoralis infection was 3.4% (6/178). Individuals infected with S. stercoralis from rural areas (50.0%; 3/6) also showed S. stercoralis hyperinfection (>3,000 larvae/gram of feces). The frequency of circulating anti-S. stercoralis IgG antibodies was 20.8% (37/178)., Conclusions: HTLV-1-infected people living in precarious sanitary conditions are more prone to develop severe forms of S. stercoralis infection. Considering the high susceptibility and unfavorable outcome of the infection in these individuals, the serological diagnosis for S. stercoralis should be considered when providing treatment.

The disease caused by the new type of coronavirus, Covid-19, has posed major public health challenges for many countries. With its rapid spread, since the beginning of the outbreak in December 2019, the disease transmitted by SARS-CoV-2 has already caused over 2 million deaths to date. In this work, we propose a web solution, called Heg.IA, to optimize the diagnosis of Covid-19 through the use of artificial intelligence. Our system aims to support decision-making regarding to diagnosis of Covid-19 and to the indication of hospitalization on regular ward, semi-ICU or ICU based on decision a Random Forest architecture with 90 trees. The main idea is that healthcare professionals can insert 41 hematological parameters from common blood tests and arterial gasometry into the system. Then, Heg.IA will provide a diagnostic report. The system reached good results for both Covid-19 diagnosis and to recommend hospitalization. For the first scenario we found average results of accuracy of 92.891%±0.851, kappa index of 0.858 ± 0.017, sensitivity of 0.936 ± 0.011, precision of 0.923 ± 0.011, specificity of 0.921 ± 0.012 and area under ROC of 0.984 ± 0.003. As for the indication of hospitalization, we achieved excellent performance of accuracies above 99% and more than 0.99 for the other metrics in all situations. By using a computationally simple method, based on the classical decision trees, we were able to achieve high diagnosis performance. Heg.IA system may be a way to overcome the testing unavailability in the context of Covid-19.Communicated by Ramaswamy H. Sarma.

This study assessed the potential of eugenol and the essential oil of Lippia alba (EOLA) in providing suitable anesthetic induction and recovery times, and their consequent effects on the blood and respiratory physiology, as well as the gill architecture of an Amazonian freshwater stingray, Potamotrygon wallacei, shortly after reaching the recovery and 48 h later. Juveniles of P. wallacei were exposed to increasing concentrations of eugenol (75, 100, 125, and 150 µL L -1 ) and EOLA (150, 175, 200, and 225 µL L -1 ) in an immersion bath. Anesthetic induction was found to be faster with the use of eugenol compared to EOLA. On the other hand, the stingrays anesthetized with eugenol displayed a longer recovery time than those exposed to EOLA. The highest concentrations of eugenol caused moderate to severe histological changes in the gills. No significant changes were found for hematocrit and plasma energy metabolites in the stingrays anesthetized with all concentrations of both eugenol and EOLA shortly after reaching the recovery from the ansthesia, when compared to those recovered after 48 h. Investigations regarding the potential use of these natural anesthetics are unprecedented for freshwater stingray species, and 200 μL L -1 EOLA is recommended as the most suitable anesthetic for use in juveniles of P. wallacei., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

This systematic review and meta-analysis evaluated randomized and nonrandomized studies that assessed the effect of local subgingival propolis as an adjunct to nonsurgical periodontal therapy (NSPT) in the treatment of periodontitis. A detailed search was carried out in Cochrane Library, Embase, LILACS, LIVIVO, PubMed, Scopus, and Web of Science, with no time or language restrictions. A grey literature search was also conducted. The methodology of included studies was evaluated by the Cochrane RoB2 tool. The certainty of each clinical outcome was assessed by the GRADE system. Meta-analyses of mean difference were conducted using the random-effects model, through RevMan 5.4 software. Six studies met the eligibility criteria to be synthesized in the qualitative analysis, and three studies were included in the meta-analysis. The subgingival application of propolis as an adjunct to NSPT improved probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) in most of the assessed studies. The overall mean difference in PPD reduction was 1.49 mm, 30-45 days after treatment, and 0.8 mm, 90 days after treatment, with very low level of certainty. The overall bias was scored as high risk for all included studies. The adjunctive use of locally delivered propolis associated to NSPT to treat periodontitis may improve periodontal clinical parameters, compared with NSPT alone/placebo. However, the evidence was not strong enough to safely base any clinical recommendation., (© 2021 John Wiley & Sons Ltd.)

This paper explores the main factors for mosquito-borne transmission of the Zika virus by focusing on environmental, anthropogenic, and social risks. A literature review was conducted bringing together related information from this genre of research from peer-reviewed publications. It was observed that environmental conditions, especially precipitation, humidity, and temperature, played a role in the transmission. Furthermore, anthropogenic factors including sanitation, urbanization, and environmental pollution promote the transmission by affecting the mosquito density. In addition, socioeconomic factors such as poverty as well as social inequality and low-quality housing have also an impact since these are social factors that limit access to certain facilities or infrastructure which, in turn, promote transmission when absent (e.g., piped water and screened windows). Finally, the paper presents short-, mid-, and long-term preventative solutions together with future perspectives. This is the first review exploring the effects of anthropogenic aspects on Zika transmission with a special emphasis in Brazil., (© 2021. The Author(s).)

Background: Periodically, humanity is often faced with new and emerging viruses that can be a significant global threat. It has already been over a century post-the Spanish Flu pandemic, and we are witnessing a new type of coronavirus, the SARS-CoV-2, which is responsible for Covid-19. It emerged from the city of Wuhan (China) in December 2019, and within a few months, the virus propagated itself globally now resulting more than 50 million cases with over 1 million deaths. The high infection rates coupled with dynamic population movement demands for tools, especially within a Brazilian context, that will support health managers to develop policies for controlling and combating the new virus. Methods: In this work, we propose a tool for real-time spatio-temporal analysis using a machine learning approach. The COVID-SGIS system brings together routinely collected health data on Covid-19 distributed across public health systems in Brazil, as well as taking to under consideration the geographic and time-dependent features of Covid-19 so as to make spatio-temporal predictions. The data are sub-divided by federative unit and municipality. In our case study, we made spatio-temporal predictions of the distribution of cases and deaths in Brazil and in each federative unit. Four regression methods were investigated: linear regression, support vector machines (polynomial kernels and RBF), multilayer perceptrons, and random forests. We use the percentage RMSE and the correlation coefficient as quality metrics. Results: For qualitative evaluation, we made spatio-temporal predictions for the period from 25 to 27 May 2020. Considering qualitatively and quantitatively the case of the State of Pernambuco and Brazil as a whole, linear regression presented the best prediction results (thematic maps with good data distribution, correlation coefficient >0.99 and RMSE (%) <4% for Pernambuco and around 5% for Brazil) with low training time: [0.00; 0.04 ms], CI 95%. Conclusion: Spatio-temporal analysis provided a broader assessment of those in the regions where the accumulated confirmed cases of Covid-19 were concentrated. It was possible to differentiate in the thematic maps the regions with the highest concentration of cases from the regions with low concentration and regions in the transition range. This approach is fundamental to support health managers and epidemiologists to elaborate policies and plans to control the Covid-19 pandemics., 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 © 2021 da Silva, de Lima, da Silva, Silva, Marques, de Araújo, Albuquerque Júnior, de Souza, de Santana, Gomes, Barbosa, Musah, Kostkova, dos Santos and da Silva Filho.)

Controlling the inflammatory response to restore tissue homeostasis is a crucial step to maintain tooth vitality after pathogen removal from caries-affected dental tissues. The nuclear peroxisome proliferator-activated receptor beta/delta (PPAR β / δ ) is a ligand-activated transcription factor with emerging anti-inflammatory roles in many cells and tissues. However, its expression and functions are poorly understood in human dental pulp cells (hDPCs). Thus, this study evaluated PPAR β / δ expression and assessed the anti-inflammatory effects evoked by activation of PPAR β / δ in lipopolysaccharide- (LPS-) induced hDPCs. Our results showed that hDPCs constitutively expressed PPAR β / δ mRNA/protein, and treatment with LPS increased PPARβ/δ mRNA expression. The selective PPAR β / δ agonist GW0742 significantly decreased inflammation-related mRNA expression in hDPCs ( IL6 , IL1β , TNFα , MMP1 , and MMP2 ) and RAW264.7 cells ( Il6 and Tnfα ). Further, PPAR β / δ agonist attenuated MMP2/9 gelatinolytic activity in hDPCs. Previously LPS-conditioned hDPCs increased the migration of RAW264.7 cells through the membrane of a Transwell coculture system. Conversely, pretreatment with GW0742 markedly decreased macrophage recruitment. These findings provide among the first evidence that hDPCs express PPAR β / δ . In addition, they suggest that activation of PPAR β / δ by GW0742 can attenuate some cellular and molecular in vitro aspects related to the inflammatory process, pointing out to investigate its potential target role in dental pulp inflammation., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2021 Caroline L. de Lima et al.)

Purpose: To assess the action of pentoxifylline, administered by subcutaneous route, on skin flap tissue repair in rats, and to verify the histological aspects and biomarkers., Methods: Thirty-two male Wistar rats were divided into four groups: control (CT) and treated with pentoxifylline (P1, P3 and P5). Modified McFarlane technique flap was used. Ten days later, the animals were euthanized and the areas of viable and necrotic tissue were evaluated. Hematoxylin/eosin staining was used to assess the morphometric characteristics of the number of vessels and epithelial thickness. Picrosirius red was used to assess collagen density. VEGF and TGF-?1 levels on the skin flap and serum of the animals were measured by the ELISA method., Results: The macroscopic evaluation of the skin flap dimensions showed reduced necrotic tissue in the pentoxifylline (p < 0.05) treated groups. There was an increase in angiogenesis and reepithelization, demonstrated by analyses with an increased number of vessels (p < 0.05), VEGF and epithelial thickness. Fibrogenic effect showed decreased collagen density and TGF-β1 in the skin flap and serum., Conclusion: The benefits of pentoxifylline administered by subcutaneous route, at dose 100 mg/kg, which was effective to improve the survival of skin flap by acting on tissue repair components, stimulating angiogenesis and reepithelization, in addition to reducing fibrogenesis.

Curcumin, a polyphenol isolated from the rhizome of Curcuma longa, has been studied because of its antioxidant, antimicrobial, and antiinflammatory properties. This study aimed to evaluate the effects of curcumin on head and neck cancer (HNC) cell lines and how it modulates the PI3K-AKT-mTOR signaling pathway. Dose-response curves for curcumin were established for hypopharynx carcinoma (FaDu), tongue carcinoma (SCC-9), and keratinocytes (HaCaT) cell lines and IC 50 values were calculated. Cell cycle and cell death were investigated through flow cytometry. Cytoskeleton organization was assessed through phalloidin+FITC staining. qPCR array and western blot were performed to analyze gene and protein expression. Curcumin reduced cell viability in a dose-dependent and selective manner, induced cell death on SCC-9 cells (necrosis/late apoptosis: 44% curcumin vs. 16.4% vehicle), and arrested cell cycle at phase G 2 /M on SCC-9 and FaDu (G 2 : SCC-9-19.1% curcumin vs. 13.4% vehicle; FaDu-37.8% curcumin vs. 12.9% vehicle). Disorganized cytoskeleton and altered cell morphology were observed. Furthermore, curcumin downregulated the PI3K-AKT-mTOR signaling pathway by modifying the expression of key genes and proteins. These findings highlight the promising therapeutic potential of curcumin to inhibit HNC growth and progression and to modulate the PI3K-AKT-mTOR pathway., (© 2020 John Wiley & Sons, Ltd.)

Background: The global burden of the new coronavirus SARS-CoV-2 is increasing at an unprecedented rate. The current spread of Covid-19 in Brazil is problematic causing a huge public health burden to its population and national health-care service. To evaluate strategies for alleviating such problems, it is necessary to forecast the number of cases and deaths in order to aid the stakeholders in the process of making decisions against the disease. We propose a novel system for real-time forecast of the cumulative cases of Covid-19 in Brazil. Methods: We developed the novel COVID-SGIS application for the real-time surveillance, forecast and spatial visualization of Covid-19 for Brazil. This system captures routinely reported Covid-19 information from 27 federative units from the Brazil.io database. It utilizes all Covid-19 confirmed case data that have been notified through the National Notification System, from March to May 2020. Time series ARIMA models were integrated for the forecast of cumulative number of Covid-19 cases and deaths. These include 6-days forecasts as graphical outputs for each federative unit in Brazil, separately, with its corresponding 95% CI for statistical significance. In addition, a worst and best scenarios are presented. Results: The following federative units (out of 27) were flagged by our ARIMA models showing statistically significant increasing temporal patterns of Covid-19 cases during the specified day-to-day period: Bahia, Maranhão, Piauí, Rio Grande do Norte, Amapá, Rondônia, where their day-to-day forecasts were within the 95% CI limits. Equally, the same findings were observed for Espírito Santo, Minas Gerais, Paraná, and Santa Catarina. The overall percentage error between the forecasted values and the actual values varied between 2.56 and 6.50%. For the days when the forecasts fell outside the forecast interval, the percentage errors in relation to the worst case scenario were below 5%. Conclusion: The proposed method for dynamic forecasting may be used to guide social policies and plan direct interventions in a cost-effective, concise, and robust manner. This novel tools can play an important role for guiding the course of action against the Covid-19 pandemic for Brazil and country neighbors in South America., (Copyright © 2020 de Lima, da Silva, da Silva, Luiz Silva, Marques, de Araújo, Albuquerque Júnior, de Souza, de Santana, Gomes, de Freitas Barbosa, Musah, Kostkova, dos Santos and da Silva Filho.)

Aims: We investigate the effects of RT on the mechanical function, gene, and protein expression of key factors involved in bone remodeling during aging., Main Methods: Male rats of 3 and 21 months of age were randomly allocated into four groups (8 per group): young sedentary (YS), young trained (YT), old sedentary (OS), and old trained (OT). RT was performed three times per week (12 weeks). Bone tenacity and stiffness were measured by biomechanical tests and mRNA levels of COL1A1, MEPE, SOST, OPG, BMP-2, PPAR-y, MMP-2-9-13, and TIMP-1 were evaluated by quantitative PCR. COL1A1 protein and MMP-2 activity were detected by western blotting and zymography assays., Key Findings: Aging increased stiffness, while BMP-2, OPG, COL1A1 and MMP-2 mRNA levels reduced (OS vs YS; p ≤ 0.05). RT increased the tenacity of the femur and reduced PPAR-γ regardless of age (YT vs. YS; OT vs. OS; p ≤ 0.05). RT downregulated SOST mRNA levels only in the OT group (vs. OS group, p ≤ 0.05). RT mitigated the age-associated increase in MMP-9 mRNA levels (p ≤ 0.05). In young animals, upregulation in MEPE, MMP-13, TIMP-1 were observed after RT, as well an increase in COL1A1 protein and MMP-2 activity (p ≤ 0.05)., Significance: RT improved bone tenacity independent of aging, which is relevant for mechanical function, while, at protein levels, RT upregulated MMP-2 activity and collagen 1 only in young rats. This study highlights the importance of exercise on bone health and identifies specific molecular changes in response to RT. Our findings provide insights into the mechanisms involved in age-related changes., Competing Interests: Declaration of competing interest 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 © 2020 Elsevier Inc. All rights reserved.)

Background: Spiny keratoderma shows "music box spine" keratotic papules limited to the palms and soles and these lesions do not cause any trouble besides the cosmetic impairment and the sensation of roughness of hands and soles., Aim: To present cases and review the literature on spiny keratoderma., Patients/methods, Results: Three cases of spiny keratoderma are presented. The first case is a 52-year-old man with protein S deficiency presented with multiple spiny keratotic papules on palms and soles for more than 30 years, referring to remove them with a razor blade. The second case is an 84-year-old man who was hospitalized due to a rectal adenocarcinoma diagnosed 2 months before and presented multiples papules on palms and soles that were present for more than 50 years, with worsening after being bedridden. The third case is a 59-year-old woman who had since birth together with relatives the same type of spiny keratotic papules on palms and soles., Conclusion: The authors discuss the epidemiologic data and differential diagnosis of spiny keratoderma, as well as the related literature. Associations with systemic disease or malignancy occur in some acquired cases. It is important to distinguish from other palmoplantar keratodermas as some of that can be linked to cutaneous and internal malignancies. To date, no cases of spiny keratoderma in patients with protein S deficiency and only one case of association with rectal carcinoma have been reported., (© 2019 Wiley Periodicals, Inc.)

Introduction: Insufficient hair growth after hair transplant, as well as erythema and perifollicular scaling, may be diagnosed as lichen planopilaris and treated as such based on clinical and histopathological findings. The purpose of this study is to observe graft biopsies of patients after uncomplicated hair transplants and to discuss if histological findings are enough to diagnose lichen planopilaris., Methods and Results: Eight patients diagnosed with androgenetic alopecia who were submitted to hair transplant were enrolled. In each of the participants, a scalp biopsy was performed in the receptor area and in the adjacent area. Biopsies were performed between 6 months and 1 year after surgery. Exams were analyzed by 3 pathologists. The t test was performed for paired observations, comparing the transplanted and the nontransplanted area for lymphocytic infiltrate and fibrosis. The significance level was considered as 5% ( p < 0.05). Four of 8 participants had perifollicular lymphocytic infiltrate, from moderate to dense intensity in the recipient area. Fibrosis was seen in 6 patients. These findings were not seen in the control area., Conclusions: It is questioned whether lymphocytic infiltrate and fibrosis may be expected in patients who are submitted to normal hair transplants., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2020 by S. Karger AG, Basel.)

Novel adjunctive screening aids are needed to reduce the morbidity and mortality related to cancer, and every effort should be made for early diagnosis. This systematic review aimed to evaluate salivary metabolites and their diagnostic value in patients with cancer.The systematic review was performed in two phases and included studies that focused on the diagnostic value of salivary metabolites in humans with solid malignant neoplasms. Five electronic databases were searched, and the risk of bias in individual studies was evaluated using the revised Quality Assessment of Diagnostic Accuracy Studies criteria (QUADAS-2). All procedures were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Of the 1151 studies retrieved, 25 were included; 13 studies used targeted and 12 untargeted metabolomics approaches. Most studies included patients with breast and oral cancer. Except for one, all studies had case-control designs, and none fulfilled all quality assessments. Overall, 140 salivary metabolites were described. The most frequently reported metabolites were alanine, valine, and leucine. Among the 11 studies that reported diagnostic test accuracy (DTA) values, proline, threonine, and histidine in combination and monoacylglycerol alone demonstrated the highest DTA for breast cancer. Combined choline, betaine, pipecolinic acid, and L-carnitine showed better discriminatory performance for early oral cancer.This systematic review highlights the current evidence on salivary metabolites that may be used as a future strategy to diagnose cancer. Further studies including larger sample sizes with confirmation of the results by untargeted analysis are warranted.

An outbreak of bloodstream infection (BSI) caused by members of the Burkholderia cepacia complex (Bcc) took place from March 2012 until April 2014 involving thirteen patients., Aim: To describe an outbreak investigation of BSI Bcc and showing how genetic sequencing tools contributed to confirm the hypothesis of extrinsic contamination proposed by an observational study., Methods: The Infection Control Department revised and reinforced good practices of infusion therapy and catheter care, visits to affected wards, a case control study, and environmental screening based on the case-control findings., Results: Data from the case-control study found an association of cases with central venous catheter (OR 1.36; CI 1.15-1.67) and intravenous cisatracurium use (OR 10.75; CI 1.67-68.89). Visits to the operatory block revealed problems related to the cold chain used for the preservation of thermolabile cisatracurium. We could not retrieve Bcc from environmental samples using classic microbiology. New samples from the same surfaces were obtained for genetic sequencing. Bcc was identified in the cooler box, refrigerator and reusable ice packages., Conclusion: Environmental screening using genetic sequencing proved to be a useful tool for confirming our hypothesis of extrinsic contamination raised by the case-control study.

Background: Gait disorders in individuals with Parkinson's disease (PD) may be associated with alterations in the motor control system and aggravated by psychoemotional and cognitive issues. Therapeutic strategies aimed at self-perception and motor regulation seem to be promising. Motor imagery (MI) has been shown to be one of these strategies, but there is still no clear evidence of its applicability in this population. The aim of this trial is to determine the effects of motor-imagery training on the gait and electroencephalographic activity of individuals with PD., Methods/design: The sample will consist of 40 individuals, aged between 45 and 75 years, in the mild and moderate phase of the disease, with the ability to generate voluntary mental images. They will be assessed for cognitive level, degree of physical disability, mental-image clarity, kinematic gait variables, electroencephalographic activity and mobility. Next, subjects will be randomly assigned to an experimental group (EG) and a control group (CG). The EG will perform motor imagery and gait, while the CG will only engage in gait exercises. Twelve training sessions will be conducted lasting up to 90 min each, three times a week, for 4 weeks. The subjects will be reassessed on the kinematic variables of gait, electroencephalographic activity and mobility at 1, 7 and 30 days after the final training session., Discussion: The results may provide an important advance in neurological rehabilitation where an easy-access and low-cost intervention may help to improve gait, electroencephalographic activity and mobility in individuals with PD., Trial Registration: Clinicaltrials.gov, ID: NCT03439800. Registered on 15 November 2017.