Thyroid hormone profile is related to prognosis in acute decompensation of cirrhosis.

Objective: To investigate the prognostic significance of thyroid hormone profile in patients hospitalized for decompensated cirrhosis. Subjects and methods: Prospective cohort study that included 119 subjects. All subjects were evaluated at admission and followed for 90 days. TSH, fT3, fT4 were measured within 24 hours of hospitalization. Results: Higher fT4 and lower fT3 levels were observed among Child-Pugh C patients as compared to Child-Pugh A and B, and in those with acute-on-chronic liver failure (ACLF). Lower fT3/fT4 ratio was observed in those with ascites, infections, ACLF, and in Child-Pugh C. Ninety-day mortality was 26.9% and it was independently associated with higher Model for End-stage Liver Disease (MELD) and TSH, and lower fT3/fT4 ratio in multivariate analysis. A new prognostic model including MELD, TSH and fT3/fT4 ratio was devised. The areas under the receiver operating characteristic curves for MELD, fT3/fT4 ratio, TSH (µIU/mL), and the new model for predicting 90-day mortality were 0.847 ± 0.041, 0.841 ± 0.039, 0.658 ± 0.062, and 0.899 ± 0.031, respectively. The 90-day survival was 31.6% in patients with values of the predictive model ≥ -0.77 and 93.5% for values < -0.77 (P < 0.001). Conclusions: Thyroid hormone profile was strongly associated with worse outcomes in patients with cirrhosis and might represent promising prognostic tools that can be incorporated in clinical practice.

Relación entre diabetes mellitus y periodontitis apical de origen endodóntico. Revisión narrativa / Relationship between diabetes mellitus and apical periodontitis of endodontic origin. Narrative review

La diabetes mellitus es una enfermedad metabólica que se caracteriza por tener un aumento en los niveles de glucemia, causando un estado inflamatorio sistémico que puede afectar la cicatrización de las lesiones periapicales presentes en la periodontitis apical, una enfermedad inflamatoria crónica causada por una infección endodóntica cuyo desarrollo está regulado por la respuesta inmunitaria del huésped. La diabetes podría interactuar con la periodontitis apical al desencadenar la modulación inmunitaria, pudiendo afectar la respuesta clínica de las lesiones periapicales e interferir con la cicatrización después del tratamiento endodóntico. El objetivo de esta revisión de la literatura es analizar la evidencia respecto a la relación entre la diabetes mellitus y la presencia y severidad de la periodontitis apical de origen endodóntico. Se recopilaron artículos de las bases de datos PubMed, Scopus y Web of Science entre los años 2016 y 2021. Se eligieron 31 artículos pertinentes para el estudio. En el 41,6% de los estudios se encontró una mayor presencia de periodontitis apical en pacientes con diabetes asociada a una lesión apical más compleja y comprometida. Un 25% de los estudios encontró que los pacientes diabéticos mal controlados presentan mayor presencia de periodontitis apical. Un 25% de los estudios encontró que niveles altos de HbA1c se asocian a la presencia de periodontitis apical. Se encontró una relación entre la diabetes y la periodontitis apical, por lo que la diabetes debe ser considerada como un factor preoperatorio importante en el desarrollo y severidad de la periodontitis apical, sin embargo, se deben realizar estudios experimentales más estandarizados para poder determinar con mayor exactitud esta relación, además de poder indagar la bidireccionalidad entre ambos.(AU)

Diabetes mellitus is a metabolic disease that is characterized by an increase in blood glucose levels, causing a systemic inflammatory state that can affect the healing of periapical lesions present in apical periodontitis, a chronic inflammatory disease caused by an endodontic infection whose development is regulated by the host's immune response. Diabetes could interact with apical periodontitis by triggering immune modulation, being able to affect the clinical outcome of periapical lesions and interfering with healing after endodontic treatment. The objective of this literature review is to analyze the evidence regarding the relationship between diabetes mellitus and the presence and severity of apical periodontitis of endodontic origin. Articles were collected from the PubMed, Scopus and Web of Science databases between the years 2016 and 2021. 31 relevant articles were included for this study. In 41.6% of the studies a greater presence of apical periodontitis was found in patients with diabetes associated with a more complex and compromised apical lesion. 25% of the studies reported that poorly controlled diabetic patients had a greater presence of apical periodontitis. 25% of the studies reported high levels of HbA1c in association with apical periodontitis. A relationship was found between diabetes and apical periodontitis, which means diabetes should be considered as an important preoperative factor in the development and severity of apical periodontitis; however, more standardized experimental studies should be carried out to determine this relationship more accurately, in addition to being able to investigate a bidirectionality between the two.(AU)

SimuVet: a preliminary study of the innovative development of a simulator for epidural anesthesia training in dogs.

Epidural anesthesia in dogs is a locoregional anesthesia technique used in veterinary medicine, becoming an important integrated application in the anesthetic protocol to provide safer and more effective analgesia to patients. For this, professionals must adhere to rigorous guidelines and possess technical skills. In this context, in veterinary education, the development of practical clinical skills represents a crucial aspect in the training of these professionals. However, traditional teaching methods have proven insufficient to ensure a consistent level of competence among recent graduates. The introduction of non-animal alternatives for educational purposes has contributed to the development of simulation-based teaching, an innovative and accessible field capable of enhancing pre-clinical proficiency in students and reducing the use of live animals and cadavers. Despite its application in various areas of veterinary education, there are no conclusive results regarding the development of accessible simulators capable of effectively enhancing training in epidural anesthesia in dogs. Therefore, this article represents a pioneering study aimed at sharing a method for creating SimuVet, a realistic simulator for training epidural anesthesia in dogs. The simulator was fully developed by veterinary researchers with limited experience in 3D printing and, after preliminary analysis, demonstrated excellent performance and ultrasonographic anatomy. Future work will focus on the formal validation of this simulator with the aim of improving the teaching and learning process for students and experts in performing epidural anesthesia in companion animals.

Coastal natural products: a review applied to antimycobacterial activity.

Despite the many advances in drug research, natural products are still being explored as a promising source for discovering new bioactive compounds to treat global diseases such as tuberculosis. However, there is a lack of studies and information about coastal natural products, which thrive in the transitional environment between two different ecosystems and produce unique secondary metabolites. Mangroves, estuaries, and mudflats make up areas for coastal species and have shown promising results in antituberculosis research, some of them are present in hotspot areas. This review focuses on research conducted in coastal environments and explores the reasons why these natural products tend to outperform non-coastal ones against the causative agent of tuberculosis, Mycobacterium tuberculosis.

[Diagnostic performance of biliopancreatic endosonography in patients with intermediate risk of choledocholithiasis]. / Rendimiento diagnóstico de la endosonografía biliopancreática en pacientes con riesgo intermedio de coledocolitiasis.

OBJECTIVE: Determine the sensitivity and specificity of the ESBP for diagnosis in patients with intermediate risk of choledocholithiasis, referred to the specialized surgical Gastroenterology center of Unión de Cirujanos SAS - Oncologists of the West Zentria group - Manizales - Colombia between March 01, 2020 to January 31, 2022. MATERIALS AND METHODS: Retrospective cross-sectional study in patients with intermediate risk for choledocholithiasis. The diagnostic performance of ESBP was calculated and confirmed with ERCP. Negative ESBPs were followed up by telephone. RESULTS: 752 cases with ESBP were analyzed, of which 43.2% (n=325) were positive and 56.8% (n=427) were negative. ERCP was performed in positive cases who accepted the procedure (n=317); 73.5% (n:233) were positive for choledocholithiasis, 25.8% (n=82) tumors and 0.6% (n=2) biliary roundworms. Patients with positive ESBP underwent ERCP. S= 98.3% (95% CI: 95.7-99.5) was obtained; E= 88.1% (95% CI: 79.2-94.1); PPV = 95.8% (95% CI: 92.4-98.0); NPV = 94.9% (95% CI: 87.4-98.7). The AUC of ESBP was 0.9319 (95% CI 0.8961-0.967). CONCLUSION: In patients with intermediate risk for choledocholithiasis, ESBP is a useful diagnostic option in the study of pancreatic pathologies, extrahepatic biliary tree, and the identification of biliary microlithiasis; Therefore, it also allows us to complement it with a therapeutic intervention such as ERCP in a single time.

Binding Evolution of the Dengue Virus Envelope Against DC-SIGN: A Combined Approach of Phylogenetics and Molecular Dynamics Analyses Over 30 Years of Dengue Virus in Brazil.

The Red Queen Hypothesis (RQH), derived from Lewis Carroll's "Through the Looking-Glass", postulates that organisms must continually adapt in response to each other to maintain relative fitness. Within the context of host-pathogen interactions, the RQH implies an evolutionary arms race, wherein viruses evolve to exploit hosts and hosts evolve to resist viral invasion. This study delves into the dynamics of the RQH in the context of virus-cell interactions, specifically focusing on virus receptors and cell receptors. We observed multiple virus-host systems and noted patterns of co-evolution. As viruses evolved receptor-binding proteins to effectively engage with cell receptors, cells countered by altering their receptor genes. This ongoing mutual adaptation cycle has influenced the molecular intricacies of receptor-ligand interactions. Our data supports the RQH as a driving force behind the diversification and specialization of both viral and host cell receptors. Understanding this co-evolutionary dance offers insights into the unpredictability of emerging viral diseases and potential therapeutic interventions. Future research is crucial to dissect the nuanced molecular changes and the broader ecological consequences of this ever-evolving battle. Here, we combine phylogenetic inferences, structural modeling, and molecular dynamics analyses to describe the epidemiological characteristics of major Brazilian DENV strains that circulated from 1990 to 2022 from a combined perspective, thus providing us with a more detailed picture on the dynamics of such interactions over time.

Detection of Mtb and NTM: preclinical validation of a new asymmetric PCR-binary deoxyribozyme sensor assay.

Tuberculosis (TB) and infectious diseases caused by non-tuberculous mycobacteria (NTM) are global concerns. The development of a rapid and accurate diagnostic method, capable of detecting and identifying different mycobacteria species, is crucial. We propose a molecular approach, the BiDz-TB/NTM, based on the use of binary deoxyribozyme (BiDz) sensors for the detection of Mycobacterium tuberculosis (Mtb) and NTM of clinical interest. A panel of DNA samples was used to evaluate Mtb-BiDz, Mycobacterium abscessus/Mycobacterium chelonae-BiDz, Mycobacterium avium-BiDz, Mycobacterium intracellulare/Mycobacterium chimaera-BiDz, and Mycobacterium kansasii-BiDz sensors in terms of specificity, sensitivity, accuracy, and limit of detection. The BiDz sensors were designed to hybridize specifically with the genetic signatures of the target species. To obtain the BiDz sensor targets, amplification of a fragment containing the hypervariable region 2 of the 16S rRNA was performed, under asymmetric PCR conditions using the reverse primer designed based on linear-after-the-exponential principles. The BiDz-TB/NTM was able to correctly identify 99.6% of the samples, with 100% sensitivity and 0.99 accuracy. The individual values of specificity, sensitivity, and accuracy, obtained for each BiDz sensor, satisfied the recommendations for new diagnostic methods, with sensitivity of 100%, specificity and accuracy ranging from 98% to 100% and from 0.98 to 1.0, respectively. The limit of detection of BiDz sensors ranged from 12 genome copies (Mtb-BiDz) to 2,110 genome copies (Mkan-BiDz). The BiDz-TB/NTM platform would be able to generate results rapidly, allowing the implementation of the appropriate therapeutic regimen and, consequently, the reduction of morbidity and mortality of patients.IMPORTANCEThis article describes the development and evaluation of a new molecular platform for accurate, sensitive, and specific detection and identification of Mycobacterium tuberculosis and other mycobacteria of clinical importance. Based on BiDz sensor technology, this assay prototype is amenable to implementation at the point of care. Our data demonstrate the feasibility of combining the species specificity of BiDz sensors with the sensitivity afforded by asymmetric PCR amplification of target sequences. Preclinical validation of this assay on a large panel of clinical samples supports the further development of this diagnostic tool for the molecular detection of pathogenic mycobacteria.

hsa­miR­455­3P as a predictive biomarker of anemia in patients with non­small cell lung cancer treated with carboplatin plus paclitaxel.

Lung cancer is the leading cause of cancer-related morbidity and mortality worldwide. The initial treatment of lung cancer depends on the definition of the tumor type and its staging. The most common treatment is chemotherapy, and the first-line treatment is a combination of carboplatin and paclitaxel. Although this treatment has good efficacy, there is a high prevalence of adverse events, particularly hematological reactions. Studies on new biomarkers related to these adverse events, such as circulating microRNAs (miRNAs/miRs), are important for optimizing the quality of life of patients. miRNAs have high stability in several biological fluids and they have specific expressions in different tissues or pathologies. Thus, the present study aimed to assess the relationship between circulating miRNAs and adverse hematologic reactions caused by treatment with carboplatin + paclitaxel in patients with lung cancer. Blood was collected from patients before and 15 days after chemotherapy for hematological adverse reaction analysis, microarray and quantitative (q)PCR validation. Adverse reactions were classified according to the Common Terminology Criteria for Adverse Events v4.0. Microarray analysis was performed using plasma from six patients without anemia and six patients with anemia, and nine miRNAs were differentially expressed. miR-1273g-3p, miR-3613-5p and miR-455-3p, identified using microarray, were assessed using qPCR in 20 patients without anemia and 26 patients with anemia. Bioinformatic analyses of miR-455-3p were performed using miRWalk, the Database for Annotation, Visualization and Integrated Discovery and GeneMania software. Microarray analysis of patients with and without anemia revealed nine significant differentially-expressed plasma miRNAs among these patients. Of these, miR-1273g-3p, miR-3613-5p and miR-455-3p were chosen for further assessment. Only miR-455-3p demonstrated a significant reduction in expression (P=0.04) between the groups before chemotherapy with carboplatin + paclitaxel. Bioinformatics analysis of miR-455-3p revealed a relationship between this miRNA and the hematopoietic pathway, particularly with respect to the RUNX family transcription factor 1 (RUNX1) and TAL bHLH transcription factor 1, erythroid differentiation factor (TAL1) genes. The most prevalent adverse reactions in patients with lung cancer treated with carboplatin + paclitaxel were hematological, particularly anemia. This adverse reaction, caused by dysfunction of the hematopoietic system, may be explained by a possible association between the important genes in this system, RUNX1 and TAL1, and hsa-miR-455-3p.

Whole genome sequencing identifies novel mutations in malaria parasites resistant to artesunate (ATN) and to ATN + mefloquine combination.

Introduction: The global evolution of resistance to Artemisinin-based Combination Therapies (ACTs) by malaria parasites, will severely undermine our ability to control this devastating disease. Methods: Here, we have used whole genome sequencing to characterize the genetic variation in the experimentally evolved Plasmodium chabaudi parasite clone AS-ATNMF1, which is resistant to artesunate + mefloquine. Results and discussion: Five novel single nucleotide polymorphisms (SNPs) were identified, one of which was a previously undescribed E738K mutation in a 26S proteasome subunit that was selected for under artesunate pressure (in AS-ATN) and retained in AS-ATNMF1. The wild type and mutated three-dimensional (3D) structure models and molecular dynamics simulations of the P. falciparum 26S proteasome subunit Rpn2 suggested that the E738K mutation could change the toroidal proteasome/cyclosome domain organization and change the recognition of ubiquitinated proteins. The mutation in the 26S proteasome subunit may therefore contribute to altering oxidation-dependent ubiquitination of the MDR-1 and/or K13 proteins and/or other targets, resulting in changes in protein turnover. In light of the alarming increase in resistance to artemisin derivatives and ACT partner drugs in natural parasite populations, our results shed new light on the biology of resistance and provide information on novel molecular markers of resistance that may be tested (and potentially validated) in the field.

Rendimiento diagnóstico de la endosonografía biliopancreática en pacientes con riesgo intermedio de coledocolitiasis / Diagnostic performance of biliopancreatic endosonography in patients with intermediate risk of choledocholithiasis

RESUMEN Objetivo: Determinar la sensibilidad y la especificidad de la endosonografía biliopancreática (ESBP) para diagnóstico en pacientes con riesgo intermedio de coledocolitiasis, derivados a un centro especializado de Gastroenterología quirúrgica de Unión de Cirujano SAS - Oncólogos de Occidente grupo Zentria - Manizales - Colombia entre el 01 de marzo de 2020 al 31 de enero de 2022. Materiales y métodos: Estudio retrospectivo transversal en pacientes con riesgo intermedio para coledocolitiasis. Se calculó el rendimiento diagnóstico de la ESBP y se confirmó con CPRE. Se hizo seguimiento telefónico a los ESBP negativas. Resultados: Se analizaron 752 casos con ESBP de los cuales el 43,2% (n=325) fue positivo y el 56,8% (n=427) fue negativo. Se practicó CPRE en los casos positivos que aceptaron el procedimiento (n=317); el 73,5% (n=233) fueron positivos para coledocolitiasis, el 25,8% (n=82) tumores y el 0,6% (n=2) áscaris biliares. Pacientes con ESBP positiva fueron intervenidos con CPRE. Se obtuvo S= 98,3% (IC 95%: 95,7-99,5); E= 88,1% (IC 95%: 79,2-94,1); VPP = 95,8% (IC 95%: 92,4-98,0); VPN = 94,9% (IC 95%: 87,4-98,7). El AUC de ESBP fue de 0,9319 (IC 95% 0,8961-0,967). Conclusión: En pacientes con riesgo intermedio para coledocolitiasis, la ESBP es una opción diagnostica útil en el estudio de patologías pancreáticas, árbol biliar extrahepático, y la identificación de microlitiasis biliares; por lo que nos permite además poder complementarla con una intervención terapéutica como la CPRE en un solo tiempo.

ABSTRACT Objective: Determine the sensitivity and specificity of the ESBP for diagnosis in patients with intermediate risk of choledocholithiasis, referred to the specialized surgical Gastroenterology center of Unión de Cirujanos SAS - Oncologists of the West Zentria group - Manizales - Colombia between March 01, 2020 to January 31, 2022. Materials and methods: Retrospective cross-sectional study in patients with intermediate risk for choledocholithiasis. The diagnostic performance of ESBP was calculated and confirmed with ERCP. Negative ESBPs were followed up by telephone. Results: 752 cases with ESBP were analyzed, of which 43.2% (n=325) were positive and 56.8% (n=427) were negative. ERCP was performed in positive cases who accepted the procedure (n=317); 73.5% (n:233) were positive for choledocholithiasis, 25.8% (n=82) tumors and 0.6% (n=2) biliary roundworms. Patients with positive ESBP underwent ERCP. S= 98.3% (95% CI: 95.7-99.5) was obtained; E= 88.1% (95% CI: 79.2-94.1); PPV = 95.8% (95% CI: 92.4-98.0); NPV = 94.9% (95% CI: 87.4-98.7). The AUC of ESBP was 0.9319 (95% CI 0.8961-0.967). Conclusion: In patients with intermediate risk for choledocholithiasis, ESBP is a useful diagnostic option in the study of pancreatic pathologies, extrahepatic biliary tree, and the identification of biliary microlithiasis; Therefore, it also allows us to complement it with a therapeutic intervention such as ERCP in a single time.

Impactos da pandemia do Covid-19 nos múltiplos cenários da Atenção Básica em Boa Vista / Impacts of the Covid-19 Pandemic in the Multiple Scenarios of Primary Care in Boa Vista / Impactos de la Pandemia del Covid-19 en los Múltiples Escenarios de la Atención Básica en Boa Vista

Objetivo: Descrever o processo de reorganização dos serviços de saúde em Unidades Básicas de Saúde de referência exclusiva para atendimento à COVID-19, na perspectiva do enfermeiro, no período de 2020 a 2021. Método:Trata-se de um estudo quanti-qualitativo descritivo e exploratório, delineado a partir de dados extraídos de entrevistas semiestruturadas com enfermeiros que atuam em algumas unidades básicas de saúde do município de Boa Vista, em concomitante comparação com dados epidemiológicos do período pandêmico. Noestudo foi utilizada a metodologia de análise temática ou categorial de conteúdo. Resultados:Como resultado da reorganização, destacam-se duas categorizações (infraestrutura e trabalho precário). Conclusões:Ao final, revelou-se que os sistemas de saúde privado e público não estavam preparados para atender a alta demanda de serviços diante da crise pandêmica, sendo necessária uma revisão na organização e administração dos serviços de saúde

Objective:To describe the process of reorganization of health services in Basic Health Units of exclusive reference for COVID-19 care, from the perspective of nurses, in the period from 2020 to 2021. Methods:This is a descriptive quantitative-qualitative study and exploratory, designed ofdata extracted from semi-structured interviews with nurses who work in some basic health units in the city of Boa Vista, in concomitant comparison with epidemiological data from the pandemic period. The study used thematic or categorical content analysis methodology. Results:As a result of the reorganization, two categorizations stand out (infrastructure and precarious work). Conclusions:In the end, it was revealed that theprivate and public health systems were not prepared to meet the high demand for services in the face of the pandemic crisis, requiring a review of the organization and administration of health services

Objetivo: Describir el proceso de reorganización de los servicios de salud en Unidades Básicas de Salud de referencia exclusiva para la atención de la COVID-19 desde la perspectiva del enfermero durante el período 2020 a 2021. Métodos:Se trata de un estudio cuantitativo, descriptivo y exploratorio, diseñado a partir de datos extraídos de entrevistas semiestructuradas a enfermeros que actúan en algunas unidades básicas de salud de la ciudad de Boa Vista, en comparación concomitante con datos epidemiológicos del período pandémico. En el estudio se utilizó la metodología del análisis temático o categórico del contenido. Resultados:como configuración emergen dos categorías (infraestructura y trabajo precario). Conclusión:Al final se reveló que el sistema de salud público y privado no estaba preparado para atender la alta demanda de servicios ante la crisis pandémica.

Interactions between DC-SIGN and the envelope protein from Dengue and Zika viruses: a structural perspective based on molecular dynamics and MM/GBSA analyses.

Zika virus (ZIKV) and dengue virus (DENV) share a lot of similarities being both phylogenetically closely related, share the same insect vector passage for reaching the host, affinity for the same carbohydrate receptor domains (CRDs), indicating feasible competition between them on the natural field. Here, we prospected interactions of both envelope proteins with a DC-SIGN, a transmembrane c-type lectine receptor with the most implicated CRD with the Flavivirus infection presents on dendritic cells involved in viruses replication processes into the host, and among rares CRD receptors susceptible to interacting with a broad of subtypes of DENV. Protein-protein docking procedures produced structures for molecular dynamics experiments, suggesting the most energetically favorable complex. The difference found in the deltaG results prompted the experimentation with molecular dynamics. To investigate further specific residues involved with such interactions we produced a decomposition analysis using molecular dynamics of the docked proteins evaluated afterward with the Generalized Born Surface Area method. Solvent-accessible surface area (SASA) analysis for both showed very similar but with a slight reduction for ZIKV_E, which agreed with residues SASA analysis highlighting regions more exposed in the ZIVK protein than in DENV. Despite residues PHE313 is reponsible for most of the interactions with the envelope of these arboviruses, ZIKV interacted with this residue in DC-SIGN with lower energies and using more interactions with not expexted residues GLU241 and ARG386. Taken together these results suggest better competitive interaction of ZIKV with the DC-SIGN receptor, particularly in the CRD portion.

Genotyping methods and their contributions to the study of tuberculosis dynamic in Latin America.

INTRODUCTION: Mycobacterium tuberculosis genotyping has impacted evolutionary studies worldwide. Nonetheless, its application and the knowledge generated depend on the genetic marker evaluated and the detection technologies that have evolved over the years. Here we describe the timeline of main genotypic methods related to M. tuberculosis in Latin America and the main findings obtained. METHODOLOGY: Systematic searches through the PubMed database were performed from 1993 to May 2021. A total of 345 articles met the inclusion criteria and were selected. RESULTS: Spacer oligonucleotide typing (spoligotyping) was the most widely used method in Latin America, with decreasing use in parallel with increasing use of mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) and whole genome sequencing (WGS). Among the countries, Brazil, Mexico, and Argentina had the most publications, and a considerable part of the articles were in collaboration with Latin American or non-Latin American institutions; a small proportion of studies needed partnerships to perform the genotypic methods. The genotypic methods allowed the identification of M. tuberculosis genotypes with greater capacity for clonal expansion and revealed the predominance of the Euro-American lineage in Latin America. There was a notable presence of the Beijing family in Peru and Colombia. CONCLUSIONS: The data obtained demonstrated the importance of expanding collaborative networks of tuberculosis (TB) research groups to countries with low productivity in this area, the commitment of the few Latin American countries to advance TB research, as well as the inestimable value of building a Latin America database, considering ease of population mobility between countries.

Cerebral Malaria Model Applying Human Brain Organoids.

Neural injuries in cerebral malaria patients are a significant cause of morbidity and mortality. Nevertheless, a comprehensive research approach to study this issue is lacking, so herein we propose an in vitro system to study human cerebral malaria using cellular approaches. Our first goal was to establish a cellular system to identify the molecular alterations in human brain vasculature cells that resemble the blood-brain barrier (BBB) in cerebral malaria (CM). Through transcriptomic analysis, we characterized specific gene expression profiles in human brain microvascular endothelial cells (HBMEC) activated by the Plasmodium falciparum parasites. We also suggest potential new genes related to parasitic activation. Then, we studied its impact at brain level after Plasmodium falciparum endothelial activation to gain a deeper understanding of the physiological mechanisms underlying CM. For that, the impact of HBMEC-P. falciparum-activated secretomes was evaluated in human brain organoids. Our results support the reliability of in vitro cellular models developed to mimic CM in several aspects. These systems can be of extreme importance to investigate the factors (parasitological and host) influencing CM, contributing to a molecular understanding of pathogenesis, brain injury, and dysfunction.

Revolutionizing Disease Modeling: The Emergence of Organoids in Cellular Systems.

Cellular models have created opportunities to explore the characteristics of human diseases through well-established protocols, while avoiding the ethical restrictions associated with post-mortem studies and the costs associated with researching animal models. The capability of cell reprogramming, such as induced pluripotent stem cells (iPSCs) technology, solved the complications associated with human embryonic stem cells (hESC) usage. Moreover, iPSCs made significant contributions for human medicine, such as in diagnosis, therapeutic and regenerative medicine. The two-dimensional (2D) models allowed for monolayer cellular culture in vitro; however, they were surpassed by the three-dimensional (3D) cell culture system. The 3D cell culture provides higher cell-cell contact and a multi-layered cell culture, which more closely respects cellular morphology and polarity. It is more tightly able to resemble conditions in vivo and a closer approach to the architecture of human tissues, such as human organoids. Organoids are 3D cellular structures that mimic the architecture and function of native tissues. They are generated in vitro from stem cells or differentiated cells, such as epithelial or neural cells, and are used to study organ development, disease modeling, and drug discovery. Organoids have become a powerful tool for understanding the cellular and molecular mechanisms underlying human physiology, providing new insights into the pathogenesis of cancer, metabolic diseases, and brain disorders. Although organoid technology is up-and-coming, it also has some limitations that require improvements.

Monitoring Renal Function in HIV Patients Without Kidney Disease Using Endothelial Biomarkers: A Prospective Pilot Study.

This study aimed to investigate the association between novel biomarkers and renal injury in people with HIV (PWH). A cohort study was carried out with PWH under chronic use of antiretroviral therapy (ART), followed at a public outpatient service. Clinical and laboratory parameters of the patients were evaluated year by year, from 2015 [at baseline (year 1, Y1)] to 2019 [year 5 (Y5)]. At baseline, biomarkers of renal damage (e.g., neutrophil gelatinase-associated lipocalin-NGAL, monocyte chemoattractant protein-1-MCP-1, and kidney injury molecule-1-KIM-1) and endothelial activation or glycocalyx damage [e.g., intercellular adhesion molecule 1 (ICAM-1), E-selectin, and syndecan-1] were quantified using enzyme-linked immunosorbent assays and their levels were used to classify patients into different groups. However, only syndecan-1 showed a significant correlation with serum creatinine (p < .001) and glomerular filtration rate (GFR) (p = .003) over the years. Moreover, both serum creatinine and GFR in almost 5 years were significantly associated with serum levels of syndecan-1 at baseline. The multivariate linear regression with confounders showed a significant and independent association between GFR and levels of syndecan-1 and CD4 cell count in the beginning of the study, as well as age in Y5. The data reinforce the screening for kidney diseases with novel biomarkers, especially syndecan-1, as an important strategy for a timely diagnostic and therapeutic approach.

Complications during transport of adult patients on extracorporeal membrane oxygenation.

INTRODUCTION: Transport on extracorporeal membrane oxygenation (ECMO) is a risky and complex procedure. Although most published data support the feasibility of interhospital transport on ECMO, data concerning intra-facility transportation and frequency and severity of complications during ECMO transport of adult patients are still scarce. The aim of this study was to assess transport arrangements and complications during intra and interhospital ECMO-supported patients transport at a high-volume ECMO center. METHODS: Retrospective single-center descriptive study evaluating the prevalence and severity of complications associated with the transportation of adult patients on ECMO support between 2014 and 2022 in our ECMO center. RESULTS: We performed 393 transfers of patients on ECMO support. Those comprised 206 intra-facility, 147 primary, 39 secondary and one tertiary transports. For primary and tertiary transportations, the average transfer length was 118.6 km (range 2.5-1446) and the mean total transport time was 5 h 40 min. The majority of transportations were made by ambulance (93.2%). Complications occurred in 12.7% of all transports and were more frequent in intra-facility and primary/tertiary transfers. Most complications were patient (46%) and staff related (26%). Risk category two was the most frequent (50%), and only five complications were classified as risk category 1 (10%). No deaths occurred during all patient transport. CONCLUSIONS: Most transports carry minor problems that entail a negligible risk to the patient. When ECMO-supported transport is performed by an experienced team, the severe complications are not related with an increased morbimortality.

Morphological, phylogenetic, and genomic evidence reveals the causal agent of thread blight disease of cacao in Peru is a new species of Marasmius in the section Neosessiles, Marasmius infestans sp. nov.

The thread blight disease (TBD) of cacao ( Theobroma cacao) in the department of Amazonas, Peru was recently reported to be caused by Marasmius tenuissimus (sect. Neosessiles). This same species is known to be the main causal agent of TBD in West Africa. However, some morphological characteristics, such as the presence of rhizomorphs, the almost exclusively white color, and pileus sizes less than 5 mm, among others, differ to the description of M. tenuissimus. Therefore, we aimed to conduct a taxonomic revision of the cacao-TBD causal agent in Peru, by using thorough micro and macro morphological, phylogenetic, and nuclear and mitochondrial genomic approaches. We showed that the causal agent of TBD of cacao in Amazonas, Peru, belongs to a new species, Marasmius infestans sp. nov. This study enriches our knowledge of species in the sect. Neosessiles, and strongly suggests that the M. tenuissimus species complex is highly diverse.

Role of Procrastination as a Mediator of Self-Efficacy and Emotional State in Academic Situations / Papel da Procrastinação como Mediador da Auto-Eficácia e do Estado Emocional em Situações Acadêmicas / Rol de la Procrastinación como Mediador de la Autoeficacia y el Estado Emocional en Situaciones Académicas

Abstract The need to analyze the relationship between procrastination, self-efficacy and emotional state lies on its impact on productivity, academic performance, and mental health. This research examined the role of academic procrastination as a mediator between self-efficacy and emotional state. A total of 531 university students (59.1% female) participated, with an average age of 21.69 years. The results identified that self-efficacy has a negative influence on procrastination. Likewise, the model was able to corroborate that self-efficacy decreases procrastination and produces a positive affective state. At the same time, a person with high self-efficacy can decrease their negative feelings; however, when procrastinating their negative feelings increase. Furthermore, this model did not vary between gender and academic semester groups, which shows that the results can be interpreted equivalently between these groups.

Resumo A necessidade de analisar a relação entre a procrastinação, a autoeficácia e o estado emocional está no seu impacto sobre a produtividade, o desempenho acadêmico e a saúde mental. Esta pesquisa teve como objetivo examinar o papel da procrastinação acadêmica como mediadora entre a autoeficácia e o estado emocional. Participaram 531 estudantes universitários (59,1% do sexo feminino), com idade média de 21,69 anos. Os resultados identificaram que a autoeficácia tem uma influência negativa sobre a procrastinação. Da mesma forma, o modelo foi capaz de corroborar que a autoeficácia diminui o comportamento procrastinador e produz um estado afetivo positivo. Ao mesmo tempo, uma pessoa com alta autoeficácia pode diminuir seu estado emocional negativo, porém, ao procrastinar, seu estado emocional negativo aumenta. Além disso, esse modelo foi invariável entre os grupos de gênero e semestre acadêmico, o que mostra que os resultados podem ser interpretados de forma equivalente entre esses grupos.

Resumen La necesidad de analizar la relación entre procrastinación, autoeficacia y estado emocional radica en su impacto en la productividad, rendimiento académico y salud mental. Esta investigación examinó el rol de la procrastinación académica como elemento mediador entre la autoeficacia y el estado emocional. Participaron 531 estudiantes universitarios (59.1% mujeres), con edad promedio de 21.69 años. En los resultados se identificó que la autoeficacia influye negativamente en la procrastinación. Asimismo, el modelo pudo corroborar que la autoeficacia disminuye la conducta procrastinadora y produce un estado afectivo positivo. Al mismo tiempo, una persona con alta autoeficacia puede disminuir su emocionalidad negativa, no obstante, cuando procrastina su estado emocional negativo incrementa. Además, este modelo fue invariante entre grupos de sexo y semestres académicos, lo que demuestra que se puede interpretar los resultados de forma equivalente entre estos grupos.

HCV-HIV Chronic Coinfection Prevalence in Amazon Region.

Hepatitis C virus (HCV) infection is an important public health problem, especially in areas with a low human development index such as the Amazon region. This study aimed to identify the prevalence and genotypes of HCV among people living with HIV (PLWH), both neglected chronic diseases in the Amazon region. From March 2016 to June 2017, 433 PWLH were attended to at two sexually transmitted infection referral centers in the city of Belém, in the Brazilian state of Pará in the Amazon region. All individuals were submitted to testing via the rapid immunochromatographic assay (RIA) for the qualitative detection of anti-HCV antibodies. Samples with anti-HCV antibodies were evaluated by reverse transcriptase polymerase chain reaction (RT-PCR), and samples with HCV RNA were subjected to nucleotide sequencing and phylogenetic analysis. Three (0.7%) PLWH had anti-HCV antibodies, and only one (0.2%) had HCV RNA (genotype 2); of these, 31 (7.1%) self-declared to have used drugs at least one time, and 12 (2.7%) regularly use injected drugs. One participant was elderly, single, heterosexual, with a history of unprotected sex and multiple sexual partners. This study detected a low prevalence of HCV infection and recorded the presence of HCV genotype 2 for the first time among PLWH in the Brazilian Amazon.