Corrigendum to "Once-weekly insulin icodec versus once-daily long-acting insulins for type 2 diabetes mellitus: Systematic review and meta-analysis" [Metabolism Open, 22 (2024) 100285].

[This corrects the article DOI: 10.1016/j.metop.2024.100285.].

Toxoplasma FER1 is a versatile and dynamic mediator of differential microneme trafficking and microneme exocytosis.

Toxoplasma gondii is a polarized cell concentrating several secretory organelles at the apical pole. The secretory micronemes come in two sub-populations differentiated by dependence on Rab5A/C in their biogenesis. Calcium-dependent exocytosis of micronemes occurs at the very apical tip and is critical for parasite egress from its host cell, adhesion and invasion of the next cell. Ferlins represent a protein family with roles in exocytosis containing multiple Ca2+-sensing C2 domains. We determined that T. gondii's ferlin 1 (FER1) localized dynamically to the parasite's secretory pathway. FER1 function was dissected by dominant negative overexpression strategies. We demonstrated that FER1 traffics microneme organelles along the following trajectories: (1) Along the cortex to the apical end; (2) To the apical tip for fusion with the plasma membrane; (3) Differential microneme sub-population traffic, and that FER1 could putatively be responsible for microneme protein trafficking. (4) From the trans-Golgi-endosomal network to the subpellicular cortex; (5) Retrograde transport allowing microneme recycling from mother to daughter. Finally, FER1 overexpression triggers a microneme exocytosis burst, supporting the notion that the radially organized micronemes at the apical tip comprise a readily-releasable microneme pool. In summary, FER1 is pivotal for dynamic microneme trafficking, acts differently on the two microneme subpopulations, and acts on the plasma membrane fusion step during microneme exocytosis.

First sexual maturity and type of spawning of the fish Conodon nobilis (Linnaeus, 1758) from the Amazon coast - Brazil.

The study of reproductive biology is an important tool in identifying protective measures to preserve fish stocks, providing essential data for a reliable management system that ensures a balance between the environment and the economy. This study aims to analyze the first sexual maturity and type of spawning of the fish Conodon nobilis (Linnaeus, 1758) on the Amazon coast, specifically in the Gulf Maranhense region. 360 specimens were obtained from commercial fishing activity in the community of Raposa-MA during the period from January to December 2021. Biometric data were recorded, and the gonadal maturation stages were determined through macro (maturation scale) and microscopic (histology) analyzes. Sex ratio, mean length of first sexual maturation and type of spawning were determined. Negative allometric growth was recorded for both sexes, indicating a greater increase in length than in weight, and the length varied from 11 to 31.8 cm and the sex ratio was 1 male:1.5 female. Individuals in all stages of maturation were observed throughout the year, with a predominance of individuals in spawning capacity and reproductive peaks in January, April and May, indicating that the species presents multiple spawning. The length at first sexual maturity (L50) for females was 18.41 cm and for males was 18.91 cm. Knowledge of the mean size at sexual maturity can help define appropriate regulations for fishing, ensuring that individuals have the opportunity to reproduce at least once before being captured.

Tracheostomy care for adults and the elderly in the home environment: a scoping review.

OBJECTIVE: To map out scientific knowledge regarding tracheostomy care for adults and the elderly carried out by individuals, famies or caregivers in home environments. METHOD: Scoping review, conducted in February 2023, according to the methodology of the Joanna Briggs Institute. The guiding question was: what and how should adult/elderly tracheostomy care be carried out by the individual/family/caregiver in the home environment? Studies published in Portuguese, English and Spanish were considered. The databases consulted were: Lilacs; Medline, via PubMed; Cinahl; Cochrane Library; PEDro; Embase; Scopus and Web of Science. RESULTS: 2158 articles were identified, of which 81 were read in full and 14 included in the review. The main types of care identified included psychobiological needs: airway suction, changing the tracheostomy attachment, cleaning the endocannula and sanitizing the peristomal skin. As for psychosocial needs, incentives for communication and autonomy were identified. There were no recommendations for care related to psychospiritual needs. CONCLUSION: The findings prioritize biological care, few studies have detailed how to carry out such care at home.

Oenothein B from Eugenia uniflora leaves exerts pro-angiogenic effects by increasing VEGF and TNF-α levels.

Oenothein B (OeB), a dimeric ellagitannin with a macrocyclic structure, is reported to have beneficial effects, including antioxidant, antitumor, antiviral, and antimutagenic effects, on human health. Despite the remarkable properties of OeB, its role in neovascularization process has not yet been evaluated. Thus, this study aimed to evaluate the angiogenic activity of OeB using a chorioallantoic membrane (CAM) assay at different concentrations (6.25, 12.5, and 25 µg/µL), employing digital imaging and histological analysis. Furthermore, to elucidate the mechanisms by which OeB influences angiogenesis, we assessed the levels of vascular endothelial growth factor (VEGF) and tumor necrosis factor-alpha (TNF-α) in CAM using immunohistochemical analysis. All concentrations of OeB significantly increased (p < 0.05) the percentage of vascularization as well as the levels of all the angiogenesis-associated parameters evaluated, indicating the pronounced pro-angiogenic activity of OeB. Our results showed that inflammation was one of the most relevant phenomena observed in CAM histology along with angiogenesis. In addition, a significant increase in VEGF and TNF-α levels was observed in all the CAMs compared to the negative control (p < 0.05). We suggest that OeB may induce the presence of inflammatory cells in CAM, leading to increased VEGF and TNF-α levels that result in the induction of angiogenesis. Therefore, OeB presents a favorable profile that could be further explored for the development of drugs for pro-angiogenic and tissue repair therapies.

Magnitude of change in prepartum feed intake: estimations using multiple classes of predictors and associations with transition metabolism, health, and milk production.

The objectives of this study were to identify factors associated with the relative change in prepartum dry matter intake (RCDMI) of 273 cows fed individually, evaluate the performance of linear models to estimate RCDMI using different classes of predictors, and characterize the implications of RCDMI to transition metabolism, health, and subsequent milk production. Two periods of interest were established. Period 1 comprised d -21 to -12 relative to calving, when DMI was stable. Period 2 comprised d -4 to -1, when average DMI was distinctly declined. The RCDMI from period 1 to 2 was calculated as a percentage value, which ranged from -75 to 15% and averaged -18.1% (±15.0). Season, parity, body fatness, body weight, milk production in the previous lactation and at dry-off, and length of dry period were associated with RCDMI and explained 11% of the variation in all cows, and 19% when only parous cows were considered. Performance of linear models to predict RCDMI was improved when data on rumination and physical activities and target blood metabolites were added. The adjusted R2 increased to values between 0.45 and 0.55, and selected models performed consistently in cross-validation analyses. To evaluate the implications of RCDMI, cows were ranked within parity according to RCDMI and classified into terciles as large decline (LD), moderate decline (MD), or small decline (SD). By design, DMI did not differ between tercile groups in period 1 (13.3 ± 0.2 kg/d), but differed substantially in period 2 (LD = 8.8; MD = 11.2; SD = 12.7 ± 0.2 kg/d), creating important differences in RCDMI among groups (LD = -33.8; MD = -16.2; SD = -3.4% ± 0.8%). At enrollment, cows in the LD and MD groups were heavier (LD = 788; MD = 775; SD = 750 ± 7 kg), and the proportion of cows with BCS >3.5 was higher in LD (LD = 63; MD = 47; SD = 38%). An interaction of group and time was observed for postpartum DMI, which started lower in LD than in SD cows, but equaled by the end of transition, and inverted at wk 13 and 14 after calving. Yields of energy-corrected milk were greater in LD than in SD cows, and both groups did not differ from MD (LD = 41.0; MD = 40.3; SD = 39.0 ± 0.5 kg/d). LD cows had decreased energy balance and greater concentrations of nonesterified fatty acids, ß-hydroxybutyrate, and aspartate aminotransferase in serum, and greater glutathione peroxidase activity in plasma than SD cows. Larger declines in prepartum DMI were also associated with increased risk for postpartum disease, although the associations were only weak to moderate. In conclusion, a large decline in prepartum DMI was associated with important adjustments in the energy metabolism and antioxidants activities, and greater milk production in the subsequent lactation. These findings indicate that feed intake decline close to parturition is likely a normal response to physiological adaptations at the onset of lactation when cows are fed at libitum.

Estimations of prepartum feed intake and its effects on transition metabolism and subsequent milk production.

The objectives of this study were to identify factors associated with prepartum DMI, evaluate the performance of linear models to estimate prepartum DMI using different classes of predictors, and investigate the consequences of different levels of prepartum DMI on transition metabolism and lactation performance. Individual feed intake of nulliparous (n = 100) and parous cows (n = 173) was measured by automatic feeding bins from d -35 to 98 relative to calving. Rumination and physical activities were monitored by wearable sensors. Blood metabolites were measured on d -21, -10, -3, 0, 3, 7, 10, 14, and 21. Body weight (BW) and body condition score (BCS) were assessed throughout the study. The average prepartum DMI as percentage of BW (DMIpBW) was calculated for each cow and used as dependent variable of linear models. Parity, prepartum BCS and BW, milk production in the previous lactation (M305) and at dry-off (MYDO), and length of the dry period were associated with DMIpBW and explained 41% of the variation in all cows, and 49% in parous cows. Estimations of DMIpBW were improved when data on prepartum rumination and blood metabolites were added in the predictive models. In the latter, the adjusted R-Sq increased to values between 47 and 61%, and selected models performed consistently in a 5-fold cross-validation analysis. To evaluate the implications of DMIpBW to transition metabolism and performance, cows were ranked within parity and classified into terciles as low (LFI), moderate (MFI), or high feed intake (HFI). The mean DMI was 1.44, 1.70, and 1.91 ± 0.01% of BW, respectively. No differences in BW were observed in nulliparous cows, but all 3 groups of parous cows differed (LFI = 892, MFI = 849, HFI = 798 ± 8 kg). The proportion of cows with BCS > 3.5 at enrollment differed among all groups, and averaged 67.4, 55.1, and 36.5 ± 6%, respectively. For parous cows, M305 and MYDO differed among all groups and averaged 9,808, 10,457, and 11,182 ± 233 kg, and 18.1, 23.1, and 26.2 ± 1 kg/d, respectively. After calving, DMI (LFI = 20.9, MFI = 21.9, and HFI = 22.1 ± 0.2 kg/d) and milk yield (LFI = 36.7, MFI = 38.2, and HFI = 38.3 ± 0.4 kg/d) was lower in LFI cows compared with the other 2 groups. Postpartum EBAL differed among all groups and averaged -2.79, -1.63, and -0.66 ± 0.3 Mcal/d for LFI, MFI, and HFI, respectively. During the transition period, LFI cows had higher serum concentrations of NEFA, BHB, Cl (prepartum only), and AST (postpartum only), and lower serum concentrations of cholesterol, P, GLDH, GGT (prepartum only), AST (prepartum only), urea (parous only), and SOD activity (parous only). In conclusion, a low level of prepartum DMI was associated with fatter and heavier cows, lower milk production in previous lactation, important adjustments in energy metabolism, and moderate losses in DMI and milk yield in the subsequent lactation. Moreover, the inclusion of prepartum rumination activity and target blood metabolites into predictive models improved the estimations of prepartum DMI.

Bisphenol-A induced cyto-genotoxicity on retinal pigment epithelial cells is differentially modulated by a multi-supplement containing guarana, selenium, and L-carnitine.

Bisphenol A (BPA) may adversely affect human health by inducing oxidative stress and irreversible damage to cells. Bioactive compounds found in some functional foods, individually or in combination, can attenuate the negative effects of BPA exposure; an example is the multi-supplement containing guarana (Gua), selenium (Se), and L-carnitine (LC) -GSC- which has already demonstrated antioxidant, genoprotective, and immunomodulatory activities. This study aimed to determine the effect of GSC and its constituents on oxidative and genotoxic alterations triggered by BPA exposure in the retinal epithelial cell line. The cells exposed to BPA (0.001, 0.01, 0.1, 1, 3, and 10 µM) to determine the lowest concentration required to induce cyto-genotoxicity. ARPE-19 cells were then concomitantly exposed to the selected BPA concentration, GSC, and its components (Gua, 1.07 mg/mL; Se, 0.178 µg/mL; and LC, 1.43 mg/mL). Flow cytometry, biochemical assays, qRT-PCR, genotoxicity, apoptosis, and cellular proliferation. Based on our results, 10 µM of BPA could induce cyto-genotoxic and oxidative alterations. BPA did not alter the Bcl-2/BAX expression ratio but induced Casp3 and Casp8 overexpression, suggesting that apoptosis was induced mainly via the extrinsic pathway. GSC partially reversed the alterations triggered by BPA in ARPE-19 cells. However, Se had unexpected negative effects on ARPE-19 cells. The multi-supplement GSC may attenuate changes in oxidative and genotoxic markers related to exposure of ARPE-19 cells to BPA. our results revealed that the antioxidant, anti-apoptotic, and genoprotective properties of GSC were not universally shared by its individual, once Se did not exhibit any positive impact.

Once-weekly insulin icodec versus once-daily long-acting insulins for type 2 diabetes mellitus: Systematic review and meta-analysis.

Background: Insulin icodec is a novel, long-acting, once-weekly basal insulin analog. Its comparative efficacy and safety with basal once-daily insulins in type 2 diabetes mellittus is uncertain. Objective: Evaluate potential efficacy, benefits and risks associated with icodec compared to once-daily basal insulin analogs (degludec or glargine). Methods: We systematically searched PubMed, Cochrane, and Embase for randomized controlled trials (RCTs) published until June 2023 comparing icodec versus long-acting insulin analogs (degludec and glargine) in type 2 diabetes mellitus (T2DM) with at least 12 weeks of follow-up. Binary endpoints were assessed with risk ratios (RRs) and continuous endpoints were compared using mean differences (MDs), with 95% confidence intervals (CIs). The protocol was registered in PROSPERO (CRD42023452468). Results: A total of seven RCTs and 3286 patients with T2DM were included, of whom 1509 (60.6%) received icodec treatment. The follow-up period ranged from 16 to 78 weeks. Compared with once-daily basal insulin analogs, icodec led to a greater improvement in HbA1c (MD -0.15%; 95% CI -0.21, -0.10; p < 0.0001; I2 = 0%) and time in range (TIR) (MD 2.83%; 95%CI 0.94; 4.71; p = 0.003; I2 = 22%). Body weight was increased with icodec treatment (MD 0.78 Kg; 95%CI 0.42, 1.15; p < 0.01; I2 = 86%). There was also a higher rate of injection site reactions (RR 1.89; 95%CI 1.12, 3.18; p = 0.016; I2 = 0%) and nasopharyngitis (RR 1.94; 95%CI 1.11, 3.38; p = 0.020; I2 = 0%) in the icodec group, compared with once-daily regimens. There was no significant difference between groups in fasting plasma glucose. Conclusions: In this meta-analysis of RCTs, insulin icodec led to better control of HbA1c and TIR as compared with once-daily insulin regimens, albeit with increased weight gain and a higher rate of injection site reaction in the Icodec group.

Use of rumination time in health risk assessment of prepartum dairy cows.

The objectives of this observational cohort study were to evaluate the associations of rumination time (RT) in the last week of pregnancy with transition cow metabolism, inflammation, health, and subsequent milk production, reproduction, and culling. Pregnant nulliparous (n = 199) and parous (n = 337) cows were enrolled 21 d before expected calving. Rumination time and physical activity were monitored automatically by sensors from d -21 to 15 relative to calving. Blood samples were collected on d -14, -5, 4, 8, and 12 ± 1 relative to calving. Diagnoses of clinical health problems were performed by researchers from calving to 15 DIM. In classification 1, cows were ranked based on average daily RT in the last week of pregnancy and classified into terciles as short RT (SRT), moderate RT (MRT), or long RT (LRT) for association analyses. In classification 2, RT deviation from the parity average was used in a receiver operating characteristic curve to identify the best threshold to predict postpartum clinical disease. Cows were then classified as above the threshold (AT) or below the threshold (BT). Compared with cows with LRT, cows with SRT had greater serum concentrations of nonesterified fatty acids (0.47 vs. 0.40 ± 0.01 mmol/L), BHB (0.58 vs. 0.52 ± 0.01 mmol/L), and haptoglobin (0.22 vs. 0.18 ± 0.008 g/L) throughout the transition period, and reduced concentrations of glucose, cholesterol, albumin, and magnesium in a time-dependent manner. Parous cows with SRT had higher odds of postpartum clinical disease (adjusted odds ratio [AOR] = 3.7; 95% CI: 2.1-6.4), lower odds of pregnancy by 210 DIM (AOR = 0.34; 95% CI = 0.15-0.75), and lower milk production (46.9 vs. 48.6 ± 0.5 kg/d) than parous cows with LRT. Deviation in prepartum RT had good predictive value for clinical disease in parous cows (area under the curve = 0.65; 95% CI = 0.60-0.71) but not in nulliparous (area under the curve = 0.51; 95% CI = 0.42-0.59). Separation of parous cows according to the identified threshold (≤-53 min from the parity average) resulted in differences in serum concentrations of nonesterified fatty acids (AT = 0.31 ± 0.006, BT = 0.38 ± 0.014 mmol/L), BHB (AT = 0.49 ± 0.008, BT = 0.53 ± 0.015 mmol/L), and globulin (AT = 32.3 ± 0.3, BT = 34.8 ± 0.5 g/L) throughout the transition period, as well as in serum cholesterol, urea, magnesium, albumin, and haptoglobin in a time-dependent manner. Below threshold parous cows had higher odds of clinical disease (AOR = 3.7; 95% CI = 2.1-6.4), reduced hazard of pregnancy (adjusted hazard ratio = 0.64, 95% CI: 0.47-0.89), greater hazard of culling (adjusted hazard ratio = 2.1, 95% CI: 1.2-3.6), and lower milk production (46.3 ± 0.7 vs. 48.5 ± 0.3 kg/d). External validation using data from 153 parous cows from a different herd and the established threshold in RT deviation (≤-53 min) resulted in similar predictive value, with the odds of postpartum disease 2.4 times greater in BT than AT (37.5% vs. 20.1%). In conclusion, RT in the week preceding calving was a reasonable predictor of postpartum health and future milk production, reproduction, and culling in parous cows but not in nulliparous cows.

Endometrial endometrioid adenocarcinoma with a malignant squamous component: is the unusual metastatic pattern unique of these tumors?

The FIGO scheme is currently applied for tumor grading of endometrioid adenocarcinoma. The current report presents a series of ten cases of endometrioid carcinomas that when applying the FIGO grading does not fully convey the true biological nature of the disease. The squamous component of these tumors is malignant; it constitutes the predominant invasive component, and it often metastasizes to unconventional sites. Half of the cohort developed distant disease recurrence within 2 years, even those with early-stage disease. Somatic mutations were analyzed, targeting 101 genes in all ten cases, and mutations in PTEN, MMR, PIK3CA, ATM, RB1, and TP53 genes were detected, often multiple mutations in the same case. None of the cases revealed unique molecular signatures or previously unreported gene mutations. Immunohistochemical staining for beta-catenin showed aberrant nuclear staining in eight of ten cases and remaining two showed cytoplasmic and membranous staining. Aggressive behavior and unusual sites of metastases are observed in this series even in low-grade tumor. The FIGO grading on smaller samples may be deceptive for these cases. Even if FIGO is applied, the pathology report should emphasize the malignant squamous component and its potential significance so that the gynecologic oncology team can formulate appropriate adjuvant treatment upfront. This case series argues that this histology should be regarded as a high-grade endometrioid carcinoma and can show unusual metastatic patterns. Further research is needed with more cases within this histologic subtype to guide recommendations on adjuvant therapies for this aggressive tumor type.

Potential application of munguba butter in the formulation of nanoemulsified systems.

Munguba butter has bioactive compounds such as vitamin E and phytosterols, which has valued its application in the development of new products, with advantages in its use in emulsified formulations. Therefore, the objective was to develop and evaluate the stability of a nanoemulsion containing munguba butter as the oily phase. Munguba butter was extracted by the ultrasound assisted method and its HLB (hydrophilic-lipophilic balance) was determined. Next, formulations varying the concentration of butter from 1-40% were developed and classified into liquid or solid emulsion and phase separation. Liquid emulsions were evaluated for hydrodynamic particle diameter, polydispersity index (PDI), Zeta potential (ζ), rheological characterization, and stability assays. The butter had an HLB of 6.98. The NE 1.0% formulation was selected and demonstrated to be unstable at high temperatures (45 ± 2 °C) and remained stable at room temperature, refrigeration and light radiation for 90 days. Munguba butter, because it has high amounts of saturated fatty acids, hinders its application in the development of new products. However, the success in the development of the NE 1.0% formulation is noteworthy, remaining stable when exposed to refrigeration, room temperature and light radiation.

Endometrial responsiveness to interferon-tau and its association with subsequent reproductive performance in dairy heifers.

Our objectives were to evaluate the endometrial responsiveness of dairy heifers to an intrauterine infusion of recombinant bovine interferon-tau (rbIFN-τ) and to associate endometrial responses to rbIFN-τ with subsequent reproductive performance. In experiments 1 and 2, cyclic heifers were enrolled in a program for synchronization of the estrous cycle, and blood sampling and ultrasonography examinations were performed on d 0, 4, 7, 11, and 14 of the estrous cycle. In experiment 1, heifers were randomly assigned to receive an intrauterine infusion containing 2 µg of rbIFN-τ (rbIFN-τ = 19) or saline control (CTRL = 19) into the uterine horn ipsilateral to the corpus luteum (CL) on d 14 of the estrous cycle. Then, 6 hours after the infusion, the infused uterine horn was flushed for sampling of the uterine luminal fluid (ULF) for composition analysis, and the endometrium was biopsied for transcriptomics. In experiment 2, 100 heifers received an intrauterine infusion of rbIFN-τ, and the same procedures for uterine sample collection were performed as described in experiment 1. After the intrauterine test, heifers were enrolled in a breeding program and classified as highly fertile (HF; pregnant at first AI) or subfertile (SF; not pregnant at first AI). Statistical analyses were performed using regression models, which included the effects of treatment (experiment 1: CTRL vs. rbIFN-τ) or fertility group (experiment 2: HF vs. SF) and block of samples. Intrauterine infusion of rbIFN-τ increased the expression of classical interferon-stimulated genes in the endometrium (e.g., ISG15, MX1, OAS2, IRF9, and USP18), and an antiviral response was predicted to be the main downstream effect of the transcriptome changes. In addition, rbIFN-τ increased the abundance of cholesterol, glycerol, and the overall concentration of oxylipins in the ULF. Analysis of endometrial transcriptome between HF and SF heifers revealed important differences in the expression of genes associated with cell signaling, metabolism, attachment, and migration, with a large representation of genes encoding extracellular matrix proteins. In general, differentially expressed genes were expected to be downregulated by IFN-τ but seemed to fail to be downregulated in SF heifers, resulting in higher expression in SF compared with HF heifers. Subfertile heifers had lower concentrations of glycerol and an altered profile of oxylipins in the ULF, with a lower abundance of oxylipins derived from arachidonic acid and dihomo-γ-linolenic acid, and a greater abundance of oxylipins derived from linoleic acid. Measurements of ovarian function did not differ between groups and, therefore, did not influence the observed results in uterine biology. Overall, the endometrial responsiveness to IFN-τ is variable among individuals and associated with subsequent fertility of heifers, indicating that communication between conceptus and endometrium is critical for the uterine receptivity and survival of pregnancy.

Caries experience, obesity and demographic factors in school children: A cluster analysis.

OBJECTIVE: To determine the association between caries experience, obesity, and socioeconomic and environmental factors in 2, 5 and 12 years-old schoolchildren. Secondarily, the influence of school infrastructure was assessed. METHODS: Primary data from 1762 schoolchildren from the municipality of Cajamar (SP, Brazil) and socioeconomic and environmental secondary data (Brazilian Census 2010, School Census, Prova Brasil/2017) were used. Caries and treatment experience (dmft/DMFT indices), dental occlusion, visible biofilm, weight and height were assessed. RESULTS: Caries experience was found in 6.5%, 40.2% and 46.5% of children at 2, 5 and 12 years, respectively. At 12y, greater caries experience was observed among children financially assisted by the Bolsa Família governmental program. Excess weight was found in 30%, 35% and 34% at 2, 5 and 12 years. At 2 and 5 years, the highest dental caries indices were associated with disadvantageous socioeconomic indicators (households water supply and sewage system, garbage collection, literate head and income), while overweight was associated with female sex and better socioeconomic aspects. At 12y, the group with obesity was characterized by low dmf+DMFT index and better household aspects, while the group with greater dmf+DMFT index comprised normal-weight children. A correlation between the percentage of caries experience and student/employee ratio of the school was observed. CONCLUSION: An association between disadvantageous socioeconomic and environmental aspects and dental caries was observed, while obesity was associated with better socioeconomic status of the schoolchildren. While no direct association was found between obesity and dental caries, the results emphasize the influence of socioeconomic/environmental variables on health outcomes.

To be or not to B27 positive: implications for the phenotypes of axial spondyloarthritis outcomes. Data from a large multiracial cohort from the Brazilian Registry of Spondyloarthritis.

BACKGROUND: There is a remarkable variability in the frequency of HLA-B27 positivity in patients with spondyloarthritis (SpA), which may be associated with different clinical presentations worldwide. However, there is a lack of data considering ethnicity and sex on the evaluation of the main clinical and prognostic outcomes in mixed-race populations. The aim of this study was to evaluate the frequency of HLA-B27 and its correlation with disease parameters in a large population of patients from the Brazilian Registry of Spondyloarthritis (RBE). METHODS: The RBE is a multicenter, observational, prospective cohort that enrolled patients with SpA from 46 centers representing all five geographic regions of Brazil. The inclusion criteria were as follow: (1) diagnosis of axSpA by an expert rheumatologist; (2) age ≥18 years; (3) classification according to ASAS axial. The following data were collected via a standardized protocol: demographic data, disease parameters and treatment historical. RESULTS: A total of 1096 patients were included, with 73.4% HLA-B27 positivity and a mean age of 44.4 (±13.2) years. Positive HLA-B27 was significantly associated with male sex, earlier age at disease onset and diagnosis, uveitis, and family history of SpA. Conversely, negative HLA-B27 was associated with psoriasis, higher peripheral involvement and disease activity, worse quality of life and mobility. CONCLUSIONS: Our data showed that HLA-B27 positivity was associated with a classic axSpA pattern quite similar to that of Caucasian axSpA patients around the world. Furthermore, its absence was associated with peripheral manifestations and worse outcomes, suggesting a relevant phenotypic difference in a highly miscegenated population.

ReScape: transforming coral-reefscape images for quantitative analysis.

Ever since the first image of a coral reef was captured in 1885, people worldwide have been accumulating images of coral reefscapes that document the historic conditions of reefs. However, these innumerable reefscape images suffer from perspective distortion, which reduces the apparent size of distant taxa, rendering the images unusable for quantitative analysis of reef conditions. Here we solve this century-long distortion problem by developing a novel computer-vision algorithm, ReScape, which removes the perspective distortion from reefscape images by transforming them into top-down views, making them usable for quantitative analysis of reef conditions. In doing so, we demonstrate the first-ever ecological application and extension of inverse-perspective mapping-a foundational technique used in the autonomous-driving industry. The ReScape algorithm is composed of seven functions that (1) calibrate the camera lens, (2) remove the inherent lens-induced image distortions, (3) detect the scene's horizon line, (4) remove the camera-roll angle, (5) detect the transformable reef area, (6) detect the scene's perspective geometry, and (7) apply brute-force inverse-perspective mapping. The performance of the ReScape algorithm was evaluated by transforming the perspective of 125 reefscape images. Eighty-five percent of the images had no processing errors and of those, 95% were successfully transformed into top-down views. ReScape was validated by demonstrating that same-length transects, placed increasingly further from the camera, became the same length after transformation. The mission of the ReScape algorithm is to (i) unlock historical information about coral-reef conditions from previously unquantified periods and localities, (ii) enable citizen scientists and recreational photographers to contribute reefscape images to the scientific process, and (iii) provide a new survey technique that can rigorously assess relatively large areas of coral reefs, and other marine and even terrestrial ecosystems, worldwide. To facilitate this mission, we compiled the ReScape algorithm into a free, user-friendly App that does not require any coding experience. Equipped with the ReScape App, scientists can improve the management and prediction of the future of coral reefs by uncovering historical information from reefscape-image archives and by using reefscape images as a new, rapid survey method, opening a new era of coral-reef monitoring.

A política nacional de práticas integrativas e complementares na grande Vitória: uma análise sobre os caminhos e proposições das PIC como proposta de tratamento de saúde do Sistema Único de Saúde (SUS) / The national policy for integrative and complementary practices in the metropolitan region of Vitória/ES: an analysis of the paths and propositions for PIC as a proposal for health treatment at the SUS / La política nacional de prácticas integrativas y complementarias en gran Vitória: un análisis sobre los caminos y proposiciones del PIC como propuesta de atención a la salud del Sistema Único de Salud (SUS)

Trata-se de uma pesquisa qualitativa que tem por objetivo investigar a implementação das Práticas Integrativas e Complementares no SUS na Grande Vitória. Como estratégia metodológica foram utilizadas as entrevistas semiestruturadas com três profissionais (servidoras públicas) que atuam neste contexto: uma professora de Educação Física, uma Psicóloga e uma Assistente Social. Os resultados indicam barreiras como o preconceito, a descrença e a falta de legitimidade das PIC, as quais dificultam tanto a atuação profissional, quanto a busca dos usuários por esses tratamentos.

Qualitative research that investigated the implementation of Integrative and Complementary Practices in SUS. As a methodological strategy, semi-structured interviews were used with three professionals (public servants) who work in this context: a physical education teacher, a psychologist and a social worker. It was identified that most of the PIC are offered in the capital city, leaving the other municipalities short of services. About these services, the professionals claim that there are barriers such as prejudice, disbelief and lack of legitimacy of the PIC, which hinder both the professional performance and the users' search for these treatments.

Investigación cualitativa que tuvo como objetivo investigar la implementación de Prácticas Integradoras y complementares en el SUS. Como estrategia metodológica, se utilizaron entrevistas semiestructuradas con tres profesionales (servidores públicos) que actúan en este contexto: una profesora de educación física, una psicóloga y una asistente social. Se identificó que la mayor parte del PIC se ofrece en la capital, quedando los demás municipios sin disponibilidad. En relación a estos servicios, los profesionales afirman que existen barreras como el prejuicio, la incredulidad y la falta de legitimidad de la PIC, que dificultan tanto la actuación profesional como la búsqueda de estos tratamientos por parte de los usuarios.

A política nacional de práticas integrativas e complementares na grande Vitória: uma análise sobre os caminhos e proposições das PIC como proposta de tratamento de saúde do Sistema Único de Saúde (SUS) / The national policy for integrative and complementary practices in the metropolitan region of Vitória/ES: an analysis of the paths and propositions for PIC as a proposal for health treatment at the SUS / La política nacional de prácticas integrativas y complementarias en gran Vitória: un análisis sobre los caminos y proposiciones del PIC como propuesta de atención a la salud del Sistema Único de Salud (SUS)

Trata-se de uma pesquisa qualitativa que tem por objetivo investigar a implementação das Práticas Integrativas e Complementares no SUS na Grande Vitória. Como estratégia metodológica foram utilizadas as entrevistas semiestruturadas com três profissionais (servidoras públicas) que atuam neste contexto: uma professora de Educação Física, uma Psicóloga e uma Assistente Social. Os resultados indicam barreiras como o preconceito, a descrença e a falta de legitimidade das PIC, as quais dificultam tanto a atuação profissional, quanto a busca dos usuários por esses tratamentos (AU).

Qualitative research that investigated the implementation of Integrative and Complementary Practices in SUS. As a methodological strategy, semi-structured interviews were used with three professionals (public servants) who work in this context: a physical education teacher, a psychologist and a social worker. It was identified that most of the PIC are offered in the capital city, leaving the other municipalities short of services. About these services, the professionals claim that there are barriers such as prejudice, disbelief and lack of legitimacy of the PIC, which hinder both the professional performance and the users' search for these treatments (AU).

Investigación cualitativa que tuvo como objetivo investigar la implementación de Prácticas Integradoras y complementares en el SUS. Como estrategia metodológica, se utilizaron entrevistas semiestructuradas con tres profesionales (servidores públicos) que actúan en este contexto: una profesora de educación física, una psicóloga y una asistente social. Se identificó que la mayor parte del PIC se ofrece en la capital, quedando los demás municipios sin disponibilidad. En relación a estos servicios, los profesionales afirman que existen barreras como el prejuicio, la incredulidad y la falta de legitimidad de la PIC, que dificultan tanto la actuación profesional como la búsqueda de estos tratamientos por parte de los usuarios (AU).

The effect of supplementary selenium source on apparent and true absorption, retention, performance, and selenium status in lactating Holstein cows.

Selenium is an essential trace mineral for dairy cattle and can be provided in the diet in various forms that may differ in bioavailability. The objective of this study was to determine how source of Se affects animal performance, Se status, retention, and apparent and true absorption. Multiparous Holstein cows (n = 24; 597 ± 49 kg of BW) were blocked by DIM (161 ± 18) and randomly assigned to receive 0.3 mg Se/kg of DM (100% of National Academies of Sciences, Engineering, and Medicine requirements) of either organic Se (ORG; selenized yeast) or inorganic Se (INO; sodium selenite). The Se premix was top dressed on a common TMR fed daily and mixed into the top 15 cm directly before feeding. Following an 11-wk adaptation period, cows received simultaneous infusions of an intraruminal isotope dose of 77Se in the same chemical form as the premix, and an intravenous dose of 82Se in an inorganic form. Infusions were followed by a 4-d period of blood and rumen fluid sampling, and total collection of feces, urine, and milk. Daily DMI (23 ± 0.6 kg), milk yield (35 ± 1.2 kg), and serum Se (0.11 ± 0.003 µg/g) were not different between treatments during the adaptation period, but milk Se concentrations were greater for ORG compared with INO. Serum 77Se maximum concentration and area under the curve (AUC) were not different between treatments for 72 h following infusion, but rumen fluid 77Se AUC was higher for ORG than INO. Apparent absorption (64% ± 1.4%), and retention (44% ± 1.5%) of the 77Se dose did not differ between treatments. True absorption was calculated using 82Se enrichment in serum and feces and was determined to be 69% ± 1.3% and did not differ between treatments. Fecal excretion of the 77Se dose was not different between treatments (36% ± 1.4%), but ORG had lower urinary excretion and higher milk excretion compared with INO. These results indicate that organic Se resulted in greater Se concentration of milk and lower urinary Se excretion into the environment, but absorption, Se status, and performance of the cow were not affected by Se source at this supplementation level.

Synchronous Epidermodysplasia Verruciformis and Intraepithelial Lesion of the Vulva Is Caused by Coinfection With Alpha-Human Papillomavirus and Beta-Human Papillomavirus Genotypes and Facilitated by Mutations in Cell-Mediated Immunity Genes.

CONTEXT.­: There have been exceedingly few reports of epidermodysplasia verruciformis (EV) or EV-like lesions in the vulva. We describe the first observation of vulvar lesions displaying synchronous EV-like histology and conventional high-grade squamous intraepithelial lesion (HSIL), a finding hitherto unreported in medical literature. OBJECTIVES.­: To describe this novel vulvar lesion with hybrid features of HSIL and EV, attempt to confirm the hypothesis of coinfection with α and ß human papillomavirus (α-HPV and ß-HPV) genotypes, and describe relevant underlying genetic mutations. DESIGN.­: Cases were retrospectively selected from our institutional archive. Detailed review of clinical information, histologic examination, and whole genome sequencing (WGS) were performed. RESULTS.­: Five samples from 4 different patients were included. Three of 4 patients had a history of either iatrogenic immune suppression or prior immune deficiency, and all 3 featured classic HSIL and EV changes within the same lesion. One patient had no history of immune disorders, presented with EV-like changes and multinucleated atypia of the vulva, and was the sole patient without conventional HSIL. By WGS, several uniquely mappable reads pointed toward infection with multiple HPV genotypes, including both α-HPVs and ß-HPVs. Mutations in genes implicated in cell-mediated immunity, such as DOCK8, CARMIL2, MST1, and others, were also found. CONCLUSIONS.­: We provide the first description of vulvar lesions harboring simultaneous HSIL and EV features in the English-language literature, a phenomenon explained by coinfection with α-HPV and ß-HPV genotypes. The finding of EV-like changes in a vulvar specimen should prompt assessment of the patient's immune status.