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Background: Interleukin-6 (IL-6) inhibitors recently emerged as a promising therapy for neuromyelitis optica spectrum disorder (NMOSD)., Objective: We performed a systematic review and meta-analysis comparing IL-6 inhibitors to placebo or traditional immunosuppressants in NMOSD., Methods: We searched PubMed, Embase, and Cochrane Central for eligible studies. Efficacy endpoints included hazard ratio (HR) for relapse, annualized relapse ratio (ARR) and Expanded Disability Status Scale (EDSS) change over time. Safety outcomes comprised any adverse event, serious adverse events and infections. Statistical analysis was performed using RevMan Web and R studio package meta. Heterogeneity was assessed with I² statistics., Results: Four studies involving 361 patients (228 treated with IL-6 inhibitors) were included. IL-6 inhibitors significantly reduced HR for relapse (HR 0.35; 95 % CI 0.23, 0.55); p < 0.00001; I² = 0 %) and ARR (mean difference -0.79 relapses/year; 95 % CI -1.54, -0.03; p = 0.04; I² = 96 %) compared to placebo or traditional immunosuppressants. No significant differences were observed in EDSS change over 24 weeks of follow-up (mean difference -0.18; 95 % CI -0.41, 0.05; p = 0.93; I² = 0 %), adverse events (odds ratio (OR) 1.59; 95 % CI 0.45, 5.63; p = 0.48; I² = 48 %), serious adverse events (OR 0.76; 95 % CI 0.40, 1.44; p = 0.50; I² = 0 %) and infection rates (OR 1.10; 95 % CI 0.67, 1.79; p = 0.71; I² = 0 %)., Conclusion: IL-6 inhibitors demonstrate superior efficacy in preventing relapses in NMOSD compared to placebo or traditional immunosuppressants, without a notable increase in safety risks., Competing Interests: Declaration of competing interest GN, ML, GM, FP, YS, PM, LM and VK: None. AF: Clinical researcher involved in ongoing trials funded by ROCHE, MERCK, NOVARTIS, NOVONORDISK, HYPERA, ACADIA., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: Encephalitis is a severe neurological syndrome for which herpesvirus and enteroviruses are the most common etiological agents. Arboviruses, a wildly diverse group of pathogens, are also critical epidemiological agents associated with encephalitis. In Brazil, little is known about the causative agents of encephalitis., Methods: We conducted a hospital surveillance for encephalitis between 2020 and 2022. Molecular (RT-PCR and qPCR) and serological (virus-specific IgM and viral antigens) techniques were performed in cerebrospinal fluid and serum samples obtained from study participants., Results: In the 43 participants evaluated, the etiologic agent or the presence of IgM was detected in 16 (37.2%). Nine (20.9%) cases were positive for chikungunya virus (CHIKV), three (7.0%) for dengue virus, two (4.7%) for human adenovirus, one (2.3%) for varicella-zoster virus, and one (2.3%) for enterovirus. Whole-genome sequencing revealed that the CHIKV identified belongs to the East/Central/South African lineage., Conclusion: Herein, CHIKV is a common pathogen identified in encephalitis cases. Our results reinforce previous evidence that chikungunya represents a significant cause of encephalitis during CHIKV outbreaks and epidemics and add to existing information on the epidemiology of encephalitis in Brazil., Competing Interests: Declarations of competing interest The authors declare no conflicts of interest., (Copyright © 2024. Published by Elsevier Ltd.)

Background: The skin of infants has important anatomical and physiological differences from that of children and adults. Because of skin immaturity, reduced mobility, neurological changes, and the need for medical devices, infants are at high risk for pressure injuries. Specific, validated tools are needed to assess the risk of pressure injuries in this population., Objectives: To assess the psychometric properties of the Italian version of Neonatal Skin Risk Assessment Scale (construct validity, internal consistency and reliability)., Method: A cross-sectional descriptive study was conducted in the neonatal units of the two Italian hospitals. 200 infants were examined 3 times by 54 nurses to assess the risk of pressure injuries. Exploratory and confirmatory factor analysis were performed jointly to assess construct validity. Internal consistency was analyzed using McDonalds omega coefficient and Cronbach's alpha, while intra and interobserver agreement using Intraclass Correlation Coefficients (ICC)., Results: Exploratory factor analysis confirmed a 2-factor model; the factor "duration and intensity of pressure" explained four subscales (mental state, mobility, activity and nutrition), while "skin immaturity" explained the subscales (general physical condition and skin moisture). Confirmatory factor analysis results indicated good model fits (X2/df = 0.84, p = 0.002, RMSEA = 0, NNFI = 1.01, NFI = 0.98 y CFI = 1 (M1 with MI). The italian-Neonatal Skin Risk Assessment Scale showed a good internal consistency, McDonalds omega coefficient and Cronbach's alpha both 0.86. An excellent intra and inter observer reliability was also observed, ICC 0.99 and 0.98 respectively., Conclusion: The psychometric characteristics indicate that the italian-Neonatal Skin Risk Assessment Scale is useful, valid and reliable for measuring risk of pressure injuries in the neonatal population., Implications for Clinical Practice: This is the first valid and reliable newborn-specific scale that assesses the presence of medical devices. Its use could enable efficient management of preventive resources, early classification of newborns at risk and assignment of preventive interventions, facilitate the development of risk assessment protocols., 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 © 2023 Elsevier Ltd. All rights reserved.)

In 2015, the Zika virus (ZIKV) emerged in Brazil, leading to widespread outbreaks in Latin America. Following this, many countries in these regions reported a significant drop in the circulation of dengue virus (DENV), which resurged in 2018-2019. We examine age-specific incidence data to investigate changes in DENV epidemiology before and after the emergence of ZIKV. We observe that incidence of DENV was concentrated in younger individuals during resurgence compared to 2013-2015. This trend was more pronounced in Brazilian states that had experienced larger ZIKV outbreaks. Using a mathematical model, we show that ZIKV-induced cross-protection alone, often invoked to explain DENV decline across Latin America, cannot explain the observed age-shift without also assuming some form of disease enhancement. Our results suggest that a sudden accumulation of population-level immunity to ZIKV could suppress DENV and reduce the mean age of DENV incidence via both protective and disease-enhancing interactions., (© 2024. The Author(s).)

Dengue fever is among the most significant public health concerns in Brazil. To date, the highest number of Dengue notifications in the Americas has been reported in Brazil, with cases accounting for a total number of 3,418,796 reported cases as of mid-December 2022. Furthermore, the northeastern region of Brazil registered the second-highest incidence of Dengue fever in 2022. Due to the alarming epidemiological scenario, in this study, we used a combination of portable whole-genome sequencing, phylodynamic, and epidemiological analyses to reveal a novel DENV-1 genotype V clade and the persistence of DENV-2 genotype III in the region. We further report the presence of non-synonymous mutations associated with non-structural domains, especially the NS2A (non-structural protein 2A), as well as describe synonymous mutations in envelope and membrane proteins, distributed differently between clades. However, the absence of clinical data at the time of collection and notification, as well as the impossibility of monitoring patients in order to observe worsening or death, restricts our possibility of correlating mutational findings with possible clinical prognoses. Together, these results reinforce the crucial role of genomic surveillance to follow the evolution of circulating DENV strains and understand their spread across the region through inter-regional importation events, likely mediated by human mobility, and also the possible impacts on public health and outbreak management.

Background: Despite growing scientific knowledge of Zika virus (ZIKV) infection, questions remain regarding ZIKV infection in pregnancy and congenital ZIKV syndrome (CZS)., Methods: The ZIKAction Paediatric Registry is an international registry of children with documented ZIKV exposure in utero and/or with confirmed or suspected CZS. Its aim is to characterize these children (i.e., clinical, radiological, neurodevelopmental features) and describe outcomes, longer-term sequelae and management through retrospective case note review. This analysis described the maternal and perinatal characteristics of children in the Registry's Bahia arm, assessed their neuroimaging, ophthalmic, hearing and electroencephalography abnormalities by microcephaly classification and reported on hospitalisations. Children born in 2015-2018 and enrolled 2020-2021 in three public health facilities in Salvador were included., Results: Of 129 (57% female) children, 15 (11·6%) had laboratory-confirmed congenital ZIKV infection and 114 (88·4%) suspected CZS. At delivery, 15 (11·6%) were normocephalic, 30 (23·3%) moderately microcephalic, and 84 (65·1%) severely microcephalic. Median birth head circumference z-score was -3·51 [IQR, -4·69,-2·73]. During follow-up, all children had abnormal neuroimaging, 80·3% (94/117) abnormal electroencephalogram, 62·2% (77/120) ophthalmic abnormalities, and 27·4% (34/124) hearing impairment. Microcephaly classification was significantly associated with gestational age, and ophthalmological and electroencephalography abnormalities. Of 125 children with hospitalisation data, 52 (41·6%) had been hospitalised by most recent follow-up, at median age of 15·8 [4·0, 34·4] months; infections were the leading cause., Conclusion: Congenital ZIKV infection is an emerging disease with a varied and incompletely understood spectrum. Continued long-term follow-up is essential to understand longer-term prognosis and to inform future health and educational needs., Competing Interests: Claire Thorne and all authors reports financial support was provided by European Commission Horizon 2020., (© 2023 The Authors.)

Integrated photonic circuits are key components for photonic quantum technologies and for the implementation of chip-based quantum devices. Future applications demand flexible architectures to overcome common limitations of many current devices, for instance the lack of tuneabilty or built-in quantum light sources. Here, we report on a dynamically reconfigurable integrated photonic circuit comprising integrated quantum dots (QDs), a Mach-Zehnder interferometer (MZI) and surface acoustic wave (SAW) transducers directly fabricated on a monolithic semiconductor platform. We demonstrate on-chip single photon generation by the QD and its sub-nanosecond dynamic on-chip control. Two independently applied SAWs piezo-optomechanically rotate the single photon in the MZI or spectrally modulate the QD emission wavelength. In the MZI, SAWs imprint a time-dependent optical phase and modulate the qubit rotation to the output superposition state. This enables dynamic single photon routing with frequencies exceeding one gigahertz. Finally, the combination of the dynamic single photon control and spectral tuning of the QD realizes wavelength multiplexing of the input photon state and demultiplexing it at the output. Our approach is scalable to multi-component integrated quantum photonic circuits and is compatible with hybrid photonic architectures and other key components for instance photonic resonators or on-chip detectors., (© 2022. The Author(s).)

Brazil experienced a large dengue virus (DENV) epidemic in 2019, highlighting a continuous struggle with effective control and public health preparedness. Using Oxford Nanopore sequencing, we led field and classroom initiatives for the monitoring of DENV in Brazil, generating 227 novel genome sequences of DENV1-2 from 85 municipalities (2015-2019). This equated to an over 50% increase in the number of DENV genomes from Brazil available in public databases. Using both phylogenetic and epidemiological models we retrospectively reconstructed the recent transmission history of DENV1-2. Phylogenetic analysis revealed complex patterns of transmission, with both lineage co-circulation and replacement. We identified two lineages within the DENV2 BR-4 clade, for which we estimated the effective reproduction number and pattern of seasonality. Overall, the surveillance outputs and training initiative described here serve as a proof-of-concept for the utility of real-time portable sequencing for research and local capacity building in the genomic surveillance of emerging viruses.

Multimode interference (MMI) devices are key components in modern integrated photonic circuits. Here, we present acoustically tuned optical switches on an (Al,Ga)As platform that enable robust, compact and fast response systems improving on recently demonstrated technology. The device consists of a 2 × 2 MMI device fine-tuned in its center region by a focused surface acoustic wave (SAW) beam working in the low GHz range. In this way, we can tune the refractive index profile over a narrow modulation region and thus control the optical switching behaviour via the applied SAW intensity. Direct tuning of the MMI device avoids losses and phase errors inherent to arrayed waveguide based switches, while also reducing the dimensions of the photonic circuit.

Definitive evidence for the direct band gap predicted for Wurtzite Gallium Phosphide (WZ GaP) nanowires has remained elusive due to the lack of strong band-to-band luminescence in these materials. In order to circumvent this problem, we successfully obtained large volume WZ GaP structures grown by nanoparticle-crawling assisted Vapor-Liquid-Solid method. With these structures, we were able to observe bound exciton recombination at 2.14 eV with FHWM of approximately 1 meV. In addition, we have measured the optical absorption edges using photoluminescence excitation spectroscopy. Our results show a 10 K band gap at 2.19 eV and indicate a weak oscillator strength for the lowest energy band-to-band absorption edge, which is a characteristic feature of a pseudo-direct band gap semiconductor. Furthermore, the valence band splitting energies are estimated as 110 meV and 30 meV for the three highest bands. Electronic band structure calculations using the HSE06 hybrid density functional agree qualitatively with the valence band splitting energies.

We experimentally demonstrate the dynamical tuning of the acoustic field in a surface acoustic wave (SAW) cavity defined by a periodic arrangement of metal stripes on LiNbO 3 substrate. Applying a dc voltage to the ends of the metal grid results in a temperature rise due to resistive heating that changes the frequency response of the device up to 0.3%, which can be used to control the acoustic transmission through the structure. The timescale of the switching is demonstrated to be of about 200 ms. In addition, we have also performed finite-element simulations of the transmission spectrum of a model system, which exhibits a temperature dependence consistent with the experimental data. The advances shown here enable easy, continuous, dynamical control and could be applied for a variety of substrates.

Purpose: Prostate cancer is one of the most common cancers in men, with higher prevalence in developed countries. Nothing much is known regarding the incidence and mortality of prostate cancer in Brazilian population or among the indigenous groups in Brazil. Therefore, this study aimed to correlate prostate-specific antigen (PSA) level and age in the tribe with Macuxi ethnicity, from the jungles of Amazon (between Brazil and Venezuela)., Patients and Methods: This was an epidemiological cross-sectional study aimed to find the correlation between age and PSA in the 110 Brazilian Indian tribal men of Macuxi ethnicity. Serum PSA levels (total and free PSA [tPSA and fPSA]) were screened and analyzed considering age groups., Results: We found that there was a significant correlation between the age and either tPSA ( p =0.016) or fPSA ( p =0.036). Interestingly, there was no correlation between tPSA and fPSA with any of the age groups, but we found a significant correlation between fPSA and tPSA in only the age groups 60-69 years and 70-80 years ( p =0.008)., Conclusion: In this study, we found a significant correlation between tPSA, fPSA, and the age of patients. However, the age-specific correlation was insignificant. From our current findings, we found that the levels of PSA may be considered as an important determinant in determining this correlation and specificity, even though more work needs to be done to verify this. Although PSA screening is a valuable research tool for male patients, the low specificity of the screening might provide false-positive results leading to overtreatment., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Introduction: In South East Asia, mosquito-borne viruses (MBVs) have long been a cause of high disease burden and significant economic costs. While in some SEA countries the epidemiology of MBVs is spatio-temporally well characterised and understood, in others such as Myanmar our understanding is largely incomplete., Materials and Methods: Here, we use a simple mathematical approach to estimate a climate-driven suitability index aiming to better characterise the intrinsic, spatio-temporal potential of MBVs in Myanmar., Results: Results show that the timing and amplitude of the natural oscillations of our suitability index are highly informative for the temporal patterns of DENV case counts at the country level, and a mosquito-abundance measure at a city level. When projected at fine spatial scales, the suitability index suggests that the time period of highest MBV transmission potential is between June and October independently of geographical location. Higher potential is nonetheless found along the middle axis of the country and in particular in the southern corridor of international borders with Thailand., Discussion: This research complements and expands our current understanding of MBV transmission potential in Myanmar, by identifying key spatial heterogeneities and temporal windows of importance for surveillance and control. We discuss our findings in the context of Zika virus given its recent worldwide emergence, public health impact, and current lack of information on its epidemiology and transmission potential in Myanmar. The proposed suitability index here demonstrated is applicable to other regions of the world for which surveillance data is missing, either due to lack of resources or absence of an MBV of interest., Competing Interests: Authors declare no competing interests.

Wurtzite semiconductor compounds have two silent modes, B 1 l and B 1 h . A silent mode is a vibrational mode that carries neither a dipole moment nor Raman polarizability. Thus, they are forbidden in both infrared reflectivity and Raman spectroscopy. Astonishingly, we detected the B 1 l mode in high-quality, ultra-narrow GaN nanowires using resonant Raman scattering, although the B 1 h was not observed, and there is no immediate explanation for this asymmetric finding. The Raman experiments were performed using several laser lines from 647 to 325 nm; the latter is a wavelength in which Raman becomes resonant. Actually, we observed the B 1 l mode only in resonance, indicating that the appearance of this mode is related to Fröhlich electron-phonon interactions; i.e., a dipole moment emerging in the B 1 l silent mode may not be present in the B 1 h mode. To shed light onto the physical origin of these observations, we performed density functional theory calculations of the lattice dynamics in GaN. We performed a careful analysis of the different physical mechanisms that allow the forbidden mode to appear to explain the physics underlying the nonzero dipole moment in the B 1 l mode, and the reason why this dipole moment is not present in the B 1 h mode.

Genitourinary cancers are significant causes of morbidity and mortality around the world. The present review summarises the current literature on suicide and its risk factors among patients with genitourinary cancers. The review was based on relevant articles published in MEDLINE, ProQuest, PsycINFO, Science Direct and Scopus databases. Patients with prostate cancer represented the most important risk group for suicide, among patients with urogenital cancers. Other risk factors are male gender, older age, white race, advanced disease, living alone and co-existing psychological comorbidities. Findings from the review call for a greater caregiver awareness on psychosocial morbidity and suicidality among genitourinary cancer patients pre- and post-treatment and their early identification, adoption of risk-reduction strategies and prompt referral for expert mental health care., (© 2017 John Wiley & Sons Ltd.)

InAs nanowires grown by vapor-liquid-solid (VLS) method are investigated by photoluminescence. We observe that the Fermi energy of all samples is reduced by ∼20 meV when the size of the Au nanoparticle used for catalysis is increased from 5 to 20 nm. Additional capping with a thin InP shell enhances the optical emission and does not affect the Fermi energy. The unexpected behavior of the Fermi energy is attributed to the differences in the residual donor (likely carbon) incorporation in the axial (low) and lateral (high incorporation) growth in the VLS and vapor-solid (VS) methods, respectively. The different impurity incorporation rate in these two regions leads to a core/shell InAs homostructure. In this case, the minority carriers (holes) diffuse to the core due to the built-in electric field created by the radial impurity distribution. As a result, the optical emission is dominated by the core region rather than by the more heavily doped InAs shell. Thus, the photoluminescence spectra and the Fermi energy become sensitive to the core diameter. These results are corroborated by a theoretical model using a self-consistent method to calculate the radial carrier distribution and Fermi energy for distinct diameters of Au nanoparticles.

Transmission of Zika virus (ZIKV) in the Americas was first confirmed in May 2015 in northeast Brazil. Brazil has had the highest number of reported ZIKV cases worldwide (more than 200,000 by 24 December 2016) and the most cases associated with microcephaly and other birth defects (2,366 confirmed by 31 December 2016). Since the initial detection of ZIKV in Brazil, more than 45 countries in the Americas have reported local ZIKV transmission, with 24 of these reporting severe ZIKV-associated disease. However, the origin and epidemic history of ZIKV in Brazil and the Americas remain poorly understood, despite the value of this information for interpreting observed trends in reported microcephaly. Here we address this issue by generating 54 complete or partial ZIKV genomes, mostly from Brazil, and reporting data generated by a mobile genomics laboratory that travelled across northeast Brazil in 2016. One sequence represents the earliest confirmed ZIKV infection in Brazil. Analyses of viral genomes with ecological and epidemiological data yield an estimate that ZIKV was present in northeast Brazil by February 2014 and is likely to have disseminated from there, nationally and internationally, before the first detection of ZIKV in the Americas. Estimated dates for the international spread of ZIKV from Brazil indicate the duration of pre-detection cryptic transmission in recipient regions. The role of northeast Brazil in the establishment of ZIKV in the Americas is further supported by geographic analysis of ZIKV transmission potential and by estimates of the basic reproduction number of the virus.

Background: The emergence of the Chikungunya virus (CHIKV) is currently expanding. In 2015, 38,332 cases of Chikungunya were reported to the Brazilian epidemiological surveillance system. Eighteen months after notification of the first case in the city of Feira de Santana, we conducted the first serosurvey to define the magnitude of transmission in a rural community in Brazil., Methodology/main Findings: The serosurvey was conducted in a random sample of 450 residences in the Chapada district, located 100 kilometers from Feira de Santana. We administered questionnaires and tested 120 sera from Chapada district residents for CHIKV IgM- and IgG-specific antibodies. An individual with CHIKV infection was defined as any person with CHIKV IgM or IgG antibodies detected in the serum. One Hundred cases of Chikungunya were reported after prolonged rainfall, which reinforced the relationship between the rainfall index and CHIKV transmission. Eighteen months after the start of the outbreak, we identified a seroprevalence of 20% (95% CI, 15.4-35%). CHIKV IgG- and IgM-specific antibodies were detected in 22/120 (18.3%) and 6/120 (5.0%) individuals, respectively. Among seropositive patients, 13/24 (54.2%) reported fever and joint pain over the previous two years (p<0.01). The rate of symptomatic CHIKV infection was 40.7%., Conclusions/significance: We identified a moderate seroprevalence of Chikungunya in the Chapada district, and in half of the confirmed CHIKV infections, patients reported arthralgia and fever over the previous two years., Competing Interests: The authors have declared that no competing interests exist.

Aim: Cardiovascular disease is the major cause of morbidity and mortality across the world. Despite health campaigns to improve awareness of cardiovascular risk factors, there has been little improvement in cardiovascular mortality. In this study, we sought to examine the association between cardiovascular risk factors and people's perception on cardiovascular risk., Methods: This was an epidemiological, cross-sectional, descriptive, prospective study of Masonic men aged >40 years in Boa Vista, Brazil. Participants completed a health survey, which included three questions about perception of their stress level, overall health status, and risk of a heart attack. In addition, demographic and biological data were collected., Results: A total of 101 Masonic men took part in the study; their mean age (± standard deviation) was 55.35±9.17 years and mean body mass index was 28.77±4.51 kg/m(2). Answers to the lifestyle questionnaire suggested an overall healthy lifestyle, including good diet and moderate exercise, although despite this ~80% were classified as overweight or obese. The majority of participants felt that they had a low stress level (66.3%), good overall general health (63.4%), and were at low risk of having a heart attack (71.3%). Masons who were overweight were significantly more likely to perceive themselves to be at risk of a heart attack (P=0.025)., Conclusion: Despite over half of participants having a moderate to high risk of cardiovascular disease according to traditional risk factors, less than a third perceived themselves to be at high risk. Public health campaigns need to better communicate the significance of traditional cardiovascular risk in order to improve awareness of risk among the general population.

Brazil has experienced an unprecedented epidemic of Zika virus (ZIKV), with ~30,000 cases reported to date. ZIKV was first detected in Brazil in May 2015, and cases of microcephaly potentially associated with ZIKV infection were identified in November 2015. We performed next-generation sequencing to generate seven Brazilian ZIKV genomes sampled from four self-limited cases, one blood donor, one fatal adult case, and one newborn with microcephaly and congenital malformations. Results of phylogenetic and molecular clock analyses show a single introduction of ZIKV into the Americas, which we estimated to have occurred between May and December 2013, more than 12 months before the detection of ZIKV in Brazil. The estimated date of origin coincides with an increase in air passengers to Brazil from ZIKV-endemic areas, as well as with reported outbreaks in the Pacific Islands. ZIKV genomes from Brazil are phylogenetically interspersed with those from other South American and Caribbean countries. Mapping mutations onto existing structural models revealed the context of viral amino acid changes present in the outbreak lineage; however, no shared amino acid changes were found among the three currently available virus genomes from microcephaly cases. Municipality-level incidence data indicate that reports of suspected microcephaly in Brazil best correlate with ZIKV incidence around week 17 of pregnancy, although this correlation does not demonstrate causation. Our genetic description and analysis of ZIKV isolates in Brazil provide a baseline for future studies of the evolution and molecular epidemiology of this emerging virus in the Americas., (Copyright © 2016, American Association for the Advancement of Science.)

A new restricted access molecularly imprinted polymer coated with bovine serum albumin (RAMIP-BSA) was synthesized, characterized and used for direct analysis of ivermectin from bovine meat samples, in a two-dimensional liquid chromatography system with UV detection. Ivermectin, 4-vynilpiridine and ethylene glycol dimethacrylate were employed as template, functional monomer and cross-linker, respectively. A BSA layer was cross-linked around the polymer, resulting in a biocompatible chemical barrier able to eliminate about 100% of protein from the samples. Ivermectin was extracted from the minced meat samples through a solvent extraction using methanol:water (70:30, v:v), and the extracts were directly injected into the two-dimensional liquid chromatography system, without any other treatment. Samples, fortified with ivermectin from 50 to 500 μg kg(-1), were used to build the analytical calibration curve (r=0.996). The limit of quantification was 50 μg kg(-1). Precision and accuracy presented variation coefficients, as well as relative errors lower than 17.0% and within -18.5% and 22.0%, respectively., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Steatocystoma simplex is an uncommon skin lesion with a histological pattern that is identical to that of steatocystoma multiplex. We are reporting this case of steatocystoma simplex for its uncommon location in the penile foreskin, and its occurrence in a Wapishana man., Case Presentation: A 56-year-old man of Wapishana ethnicity presented with complaints of referred penile discomfort and pain during sexual intercourse for 5 years. A physical examination revealed a mobile, compressible subcutaneous non-tender mass of 4 cm diameter located on the left-side of his penile foreskin. There were no signs of inflammation, no grip on the penile shaft, and no urethral discharge or enlargement of lymph nodes. We found no evidence of other cysts on cutaneous examination. We performed classical excision of the lesion under local anesthesia and confirmed the diagnosis of steatocystoma with the pathological report. As there were no complications, we discharged him the same day., Conclusion: Steatocystoma can be considered a differential diagnosis for cystic lesions on and around the penis.

Dengue remains a problem in Brazil, and a substantial number of cases that progress to death are not diagnosed by health services. We evaluated the impact of a protocol adopted by the Coroner's Office Rocha Furtado (CO-RF) for the detection of unreported deaths from dengue in Brazil. We evaluated prospectively cases of deaths referred to the CO-RF with suspicion of dengue and those referred with other diagnosis in which the pathologists suspected dengue as the cause of death. Biological material was collected from all bodies autopsied, for which the suspected cause of death was dengue, between January 2011 and December 2012. Of the 214 bodies autopsied, 134 (62.6%) tested positive for dengue; of these cases, 121 were classified as dengue according to the World Health Organization's case definition (1997 or 2009, as appropriate). Thus, CO-RF detected 90 deaths from dengue, which were not suspected during disease progression. This CO-RF protocol, through a combined effort of the surveillance and laboratory teams, increased the detection of fatal dengue cases by 5-fold. This is the largest series of autopsies performed in cases of death related to dengue in the world to date., (© The American Society of Tropical Medicine and Hygiene.)

Testicular mucinous cystadenomas are rare in urological practice, and their histogenesis, course and management are debated. We report a primary testicular mucinous cystadenoma in a 54-year old male who presented with left testicular swelling and pain. He denied having a history of cryptorchidism, testicular trauma, infections, urinary complaints, or febrile illnesses. He did not have diabetes, but was on treatment for hypertension. The patient underwent a left inguinal radical orchiectomy, and histological examination of the resected tumour confirmed a primary testicular mucinous cystadenoma. The patient had an uneventful recovery, and is being followed up. Conclusively, urologists need to maintain a high index of suspicion of these tumours and their differentiation from metastatic tumours to ensure optimal therapeutic outcomes.

Introduction: The dengue classification proposed by the World Health Organization (WHO) in 2009 is considered more sensitive than the classification proposed by the WHO in 1997. However, no study has assessed the ability of the WHO 2009 classification to identify dengue deaths among autopsied individuals suspected of having dengue. In the present study, we evaluated the ability of the WHO 2009 classification to identify dengue deaths among autopsied individuals suspected of having dengue in Northeast Brazil, where the disease is endemic., Methods: This retrospective study included 121 autopsied individuals suspected of having dengue in Northeast Brazil during the epidemics of 2011 and 2012. All the autopsied individuals included in this study were confirmed to have dengue based on the findings of laboratory examinations., Results: The median age of the autopsied individuals was 34 years (range, 1 month to 93 years), and 54.5% of the individuals were males. According to the WHO 1997 classification, 9.1% (11/121) of the cases were classified as dengue hemorrhagic fever (DHF) and 3.3% (4/121) as dengue shock syndrome. The remaining 87.6% (106/121) of the cases were classified as dengue with complications. According to the 2009 classification, 100% (121/121) of the cases were classified as severe dengue. The absence of plasma leakage (58.5%) and platelet counts <100,000/mm3 (47.2%) were the most frequent reasons for the inability to classify cases as DHF., Conclusions: The WHO 2009 classification is more sensitive than the WHO 1997 classification for identifying dengue deaths among autopsied individuals suspected of having dengue.

We demonstrate compact tunable phased-array wavelength-division multiplexers driven by surface acoustic waves (SAWs) in the low GHz range. The devices comprise two couplers, which respectively split and combine the optical signal, linked by an array of single-mode waveguides (WGs). Two different layouts are presented, in which multi-mode interference couplers or free propagating regions were separately employed as couplers. The multiplexers operate on five equally distributed wavelength channels, with a spectral separation of 2 nm. A standing SAW modulates the refractive index of the arrayed WGs. Each wavelength component periodically switches paths between the output channel previously asigned by the design and the adjacent channels, at a fixed applied acoustic power. The devices were monolithically fabricated on (Al,Ga)As. A good agreement between theory and experiment is achieved.

Background: Genital warts caused by human papillomavirus (HPV) infection are the most common sexually transmitted disease leading to anogential lesions. Although the laser therapy has been shown to be effective in a number of conditions, the use of laser diode vaporization in urological applications and the understanding on its effectiveness as a treatment for various urological conditions is limited. Therefore, the aim of this study was to evaluate the efficacy of diode laser vaporization as a treatment for genital lesions., Methods: Patients presenting with genital lesions at the urology outpatient clinic at Coronel Mota Hospital, between March 2008 and October 2014, were enrolled into the study. Data collected included age, gender, duration of the lesion, site of the lesion and numbers of the lesions, length of follow-up, recurrence of lesions after treatment and whether there were any complications., Results: A total of 92 patients were enrolled in the study; 92.4% (n = 85) male; mean age (± SD) 27.92 ± 8.272 years. The patients presented with a total of 296 lesions, with a median of 3 lesions each, including penis (n = 78), urethra (n = 4) lesions, and scrotum (n = 2) lesions. Lesions ranged in size from 0.1 to 0.5 cm(2), most commonly 0.3 cm(2) (n = 38; 41.3%), 0.4 cm(2) (n = 21; 22.8%) or 0.5 cm(2) (n = 20; 21.7%). Patients most commonly reported that they had their lesions for a duration of 12 (n = 29; 31.5%) or 6 months (n = 23; 25.0%). Eighteen patients (19.6%) had a recurrence after their 1(st)/conventional treatment. There were no incidences of post-operative infection or complications from the laser diode vaporization., Conclusions: Laser diode vaporization can be considered as an alternative method for treating genital lesions in urology, with satisfactory results in terms of pain, aesthetic and minimal recurrence.

Purpose: To evaluate the effects of preconditioning with oils mixes containing ω3/ω6/ω9 associated with micro-currents on skin repair in rats., Methods: One-hundred and eight Wistar rats randomized into G-1, G-2 and G-3 groups were treated with saline (0.9%), mix 1 (corn+soybean oils) and mix 2 (olive+canola+flaxseed oils), respectively, in a single dose (0.01ml/g) by gavage. Next, each group was subdivided into sham and stimulated subgroups. Pulsed-wave microcurrents (0.5 µA, 0.5 Hz) were applied to stimulated subgroups for 20 min. One hour later anesthetized rats were subjected to surgery. A dorsal incision (6 cm long) was carried out and closed with interrupted nylon sutures. Samples (1 cm2) were harvested from the mid-portion of the incision on the 7, 14, 21 post-operative (P.O.) days. Variables were analyzed using Mann-Whitney/Dunn tests Significance level was set to 5 % (p<0.05)., Results: Micro-currents promoted increase of exudate and reduction of epithelialization on day 7 in G1 rats. Mixes 1/2 reduced vascularization on 7/14th days P.O. Both 1/2 mixes reduced fibrosis on day 14. Preconditioning with mix 1 led to increased expression of NF-kB on the 7th day., Conclusion: Preconditioning with microcurrents has pro-inflammatory effects while oil mixes 1 and 2 decrease fibrosis and vascularization in the proliferative phase of cicatrization.

Introduction: Leiomyoma in the urethra is a rare occurrence. These are rare benign mesenchymal tumors that arise from the smooth muscle of the urethra. Such tumors often appear in females during their reproductive age (from menarche to menopause); the mean age of their appearance is approximately 41 years., Case Presentation: We report here a case of a 52-year-old White woman who presented with complaints of sporadic hematuria, dyspareunia, and feeling of nodulation in her vagina., Conclusions: Histopathological studies confirmed the urethral leiomyoma, and the surgery completely resolved the original symptoms. Although the average age of occurrence of such tumors in females is about 41 years, the present case involves an older woman of 52 years. Most importantly, the mass was located in the distal urethra, an uncommon site of presentation of leiomyoma in females.

The prospects outlined in climate scenarios produced for Brazil indicate a probable increase in the number of extreme hydrometeorological events in the coming years. Therefore, a study of the health scourges that may intensify due to these events is important. The scope of this article is to estimate the cost represented by the cases of dengue fever attributed to the 2011 disaster in Nova Friburgo (RJ). There were 1,356 suspected cases of dengue fever, 937 of which were confirmed. The total cost of the disease may have been between R$66,000 and R$499,000 taking the minimum salary as a benchmark, with approximately 70% of this amount being among the confirmed cases. The disaster caused extensive changes in the city's environment which, together with the urban sanitation and clearing up process that occurred in the post-event period, led to an increase in the number of potential mosquito breeding sites, facilitating their proliferation and increasing the number of cases of dengue fever. This was a disease that in the decade prior to the disaster recorded few cases of the disease in the municipality. This illustrates the potential of events like the one that occurred in 2011 in Nova Friburgo may have on the increase in the number of cases, and consequently on the cost of the disease.

Objective: to identify the political-pedagogical projects of the undergraduate nursing programs in Santa Catarina, Brazil according to the guidelines of the Ministries of Health and Education, considering the education of professionals under the principle of integrality., Method: documentary study with a qualitative approach. Nine projects were analyzed., Results: the colleges from the Southern region of Brazil are gradually incorporating the theoretical framework of the Brazilian health system and curricular guidelines, which includes the principle of integrality of care, into their political-pedagogical projects of undergraduate nursing programs. Some institutions strictly follow the curricular guidelines, while others make their own interpretation., Conclusion: most teaching institutions do not provide pedagogical support to students.

The aim of this investigation was to evaluate the efficiency of partial treatment of animals infested with horn flies. Forty-five Guzerat cows between 4 and 7 years of age were divided into three groups (15 cows per group). The treatments were as follows: in groups G33 and G100, 33.3 and 100% of the cows were treated with one insecticide-impregnated ear tag/animal (40% diazinon), respectively, while in the group GC, the cows were not treated (control). The flies on the cervico-dorsal-lumbar region of the cows, in all three groups, were counted every 14 days. The experiment lasted from September 2006 to September 2009. Over this period, six four-month ear tag treatments, with intervals of one to two months, were conducted on both treated groups. The animals of group G33 had a higher infection than those of group G100, and the number of flies ranged from 12 to 27 (group G33) and from 3 to 11 (group G100). However, groups G33 and G100 had lower infection levels than group GC, which presented from 45 to 87 flies. Partial treatment of cattle infested with horn flies using 40% diazinon insecticide is an efficient alternative for controlling this ectoparasite.

Photonic modulators are one of the most important elements of integrated photonics. We have designed, fabricated, and characterized a tunable photonic modulator consisting of two 180°-dephased output waveguide channels, driven by a surface acoustic wave in the GHz frequency range built on (Al,Ga)As. Odd multiples of the fundamental driven frequency are enabled by adjusting the applied acoustic power. A good agreement between theory and experimental results is achieved. The device can be used as a building block for more complex integrated functionalities and can be implemented in several material platforms.

Wurtzite InAs nanowire samples grown by chemical beam epitaxy have been analyzed by photoluminescence spectroscopy. The nanowires exhibit two main optical emission bands at low temperatures. They are attributed to the recombination of carriers in quantum well structures, formed by zincblende-wurtzite alternating layers, and to the donor-acceptor pair. The blue-shift observed in the former emission band when the excitation power is increased is in good agreement with the type-II band alignment between the wurtzite and zincblende sections predicted by previous theoretical works. When increasing the temperature and the excitation power successively, an additional band attributed to the band-to-band recombination from wurtzite InAs appears. We estimated a lower bound for the wurtzite band gap energy of approximately 0.46 eV at low temperature.

: The oscillating piezoelectric field of a surface acoustic wave (SAW) is employed to transport photoexcited electrons and holes in GaAs nanowires deposited on a SAW delay line on a LiNbO3 crystal. The carriers generated in the nanowire by a focused light spot are acoustically transferred to a second location where they recombine. We show that the recombination of the transported carriers occurs in a zinc blende section on top of the predominant wurtzite nanowire. This allows contactless control of the linear polarized emission by SAWs which is governed by the crystal structure. Additional polarization-resolved photoluminescence measurements were performed to investigate spin conservation during transport.

Bearing in mind the importance of the impacts of the oil industry on human health, this article seeks to present a methodological proposal for analysis of these aspects in environmental impact assessment studies, based on the established legal parameters and a validated matrix for the hydroelectric sector. The lack of health considerations in the environmental impact assessment was detected in most of the 21 oil production enterprises analyzed, that were licensed in the period from January 1, 2004 through October 30, 2009. The health matrix proved to be an appropriate methodological approach to analyze these aspects in the environmental licensing process, guiding decisions and interventions in socio-environmental management.

The oscillating piezoelectric field of a surface acoustic wave (SAW) is employed to transport photoexcited carriers, as well as to spatially control exciton recombination in GaAs-based nanowires (NWs) on a subns time scale. The experiments are carried out in core-shell NWs transferred to a SAW delay line on a LiNbO(3) crystal. Carriers generated in the NW by a focused laser spot are acoustically transferred to a second location, leading to the remote emission of subns light pulses synchronized with the SAW phase. The dynamics of the carrier transport, investigated using spatially and time-resolved photoluminescence, is well-reproduced by computer simulations. The high-frequency contactless manipulation of carriers by SAWs opens new perspectives for applications of NWs in opto-electronic devices operating at gigahertz frequencies. The potential of this approach is demonstrated by the realization of a high-frequency source of antibunched photons based on the acoustic transport of electrons and holes in (In,Ga)As NWs., (© 2011 American Chemical Society)

We performed a detailed investigation of the structural and optical properties of multi-layers of InP/GaAs quantum dots, which present a type II interface arrangement. Transmission electronic microscopy analysis has revealed relatively large dots that coalesce forming so-called quantum posts when the GaAs layer between the InP layers is thin. We observed that the structural properties and morphology affect the resulting radiative lifetime of the carriers in our systems. The carrier lifetimes are relatively long, as expected for type II systems, as compared to those observed for single layer InP/GaAs quantum dots. The interface intermixing effect has been pointed out as a limiting factor for obtaining an effective spatial separation of electrons and holes in the case of single layer InP/GaAs quantum-dot samples. In the present case this effect seems to be less critical due to the particular carrier wavefunction distribution along the structures.

We present the experimental observation of Bloch oscillations, the Wannier-Stark ladder, and Landau-Zener tunneling of surface acoustic waves in perturbed grating structures on a solid substrate. A model providing a quantitative description of our experimental observations, including multiple Landau-Zener transitions of the anticrossed surface acoustic Wannier-Stark states, is developed. The use of a planar geometry for the realization of the Bloch oscillations and Landau-Zener tunneling allows a direct access to the elastic field distribution. The vertical surface displacement has been measured by interferometry.

Discussing the need to implement an environmental management system in civil service entities, this paper offers a brief description of some management practices used by companies in various sectors that are endeavoring to establish the best possible relationships between business activities, environmental issues and human needs, today and in the future. Some economic arguments are presented, including the benefits obtained by private sector companies adopting eco-efficiency criteria that are in themselves sufficient to justify the implementation of an effective environmental management policy in government institutions. The relevance is also stressed of drawing up the Civil Service Environment Agenda (A3P), striving to introduce a new cultural approach that will mobilize civil servants in order to optimize resources, combating waste and encouraging better work environments. For this Agenda to be effective, civil servants and managers must obviously be fully engaged.

The taxonomic relationships among the four genera of the Atelidae family, Alouatta (Howler), Ateles (Spider), Lagothrix (Woolly) and Brachyteles (Muriqui), have been the subject of great debate. In general, almost all authors agree with the assignment of Howler monkeys as the basal genus, either in its own tribe Alouattini or in the subfamily Alouattinae, but they disagree on the associations among the other members of the family. Muriquis have been grouped with Spider monkeys based on the fact that they share various behavioral and morphological characteristics. Cladistic analyses using morphological, biochemical, karyotype and behavioral characteristics depicted a phylogenetic tree that places Howler as the basal genus and the remaining genera in an unresolved politomy. More recent studies using molecular data have suggested that Muriqui and Woolly monkeys are sister groups. However, a recent study based on nuclear and mtDNA argued that politomy is what best represents the relationships among Spider, Woolly and Muriqui. To contribute to this debate we have added new data from two nuclear genes, Transferrin and von Willebrand Factor, and using an alignment of 17,997 bp we demonstrate that a total analysis strongly supports the Muriqui-Woolly clade. A gene-to-gene approach showed that four of the eight nuclear genes provide support for the Muriqui-Woolly clade, two strongly and two moderately, while none of the eight genes provide support for any alternative arrangement. The mitochondrial genes were not able to resolve the politomy. A possible reason for the difficulty in resolving atelid relationships may be the short period of time separating each cladogenetic event in the evolutionary process that shaped this family.

We show that the coherent interaction between microcavity polaritons and externally stimulated acoustic phonons forms a tunable polariton superlattice with a folded energy dispersion determined by the phonon population and wavelength. Under high phonon concentration, the strong confinement of the optical and excitonic polariton components in the phonon potential creates weakly coupled polariton wires with a virtually flat energy dispersion.

We demonstrate the formation of a dynamic optical superlattice through the modulation of a semiconductor microcavity by stimulated acoustic phonons. The high coherent phonon population produces a folded optical dispersion relation with well-defined energy gaps and renormalized energy levels, which are accessed using reflection and diffraction experiments.

Wicket spikes (WS) are a benign electroencephalogram (EEG) variant, seen mainly in adults, during somnolence, in the temporal regions, in many clinical situations. WS can appear in trains or isolatedly, sometimes being difficult to differentiate from epileptiform activity. We reviewed 2,000 EEG's, found 65 with WS (3.25%) and compared them with 65 normal EEG without WS. There was statistically significant (SS) association between WS and age over 33; adolescent age was correlated to absence of WS and age over 65, to the presence of WS; there was an inverse correlation between WS and epilepsy, related to differences in age; a SS association with cerebrovascular disorders disappeared after controlling for age; a SS correlation with headache was also related to age; female predominance was not SS. There was a great variety of clinical situation associated with WS. We conclude that WS are a inespecific normal variant of the EEG that is age-related.

We report on the clinical and EEG features of 15 patients with the syndrome of "continuous spike waves during slow wave sleep" (CSWSS). The differential diagnosis of CSWSS includes benign epilepsy of childhood with centro-temporal spikes, and Landau-Kleffner and Lennox-Gastaut syndromes. We found normal CT and MRI features in 6 cases, periventricular leukomalacia with and without diffuse brain atrophy in 4 cases and hydrocephalus in 1 case. There was no association between specific neurological findings and CSWSS. Nine of our cases had relatively focal discharges, like some cases from the literature. The occurrence of CSWSS appears to be age-related, generally between the ages of 5 to 12 years, with a strong temporal relation to the neuropsychological deterioration in its nature, severity and prognosis. We believe that this striking disorder has been overlooked and that routine sleep EEG studies on epileptic children may disclose additional cases of CSWSS.

We report a topographic and quantitative EEG (EEGQT) study of four patients with analogic EEG diagnostics of midline foci. The new study with EEGQT offered an increased definition of the electrical source with advantages in foci localization. These findings should be confirmed with studies including a greater number of patients.