Beyond frequency: Evaluating the validity of assessing the context, duration, ability, and botherment of depression and anxiety symptoms in South Brazil.

Assessment tools for depression and anxiety usually inquire about the frequency of symptoms. However, evidence suggests that different question framings might trigger different responses. Our aim is to test if asking about symptom's context, ability, duration, and botherment adds validity to Patient Health Questionnaire-9, General Anxiety Disorder-7, and Patient-Related Outcome Measurement Information Systems depression and anxiety. Participants came from two cross-sectional convenience-sampled surveys (N = 1,871) of adults (66% females, aged 33.4 ± 13.2), weighted to approximate with the state-level population. We examined measurement invariance across the different question frames, estimated whether framing affected mean scores, and tested their independent validity using covariate-adjusted and sample-weighted structural equation models. Validity was tested using tools assessing general disability, alcohol use, loneliness, well-being, grit, and frequency-based questions from depression and anxiety questionnaires. A bifactor model was applied to test the internal consistency of the question frames under the presence of a general factor (i.e., depression or anxiety). Measurement invariance was supported across the different frames. Framing questions as ability (i.e., "How easily …") produced a higher score, compared with framing by context (i.e., "In which daily situations …"). Construct and criterion validity analysis demonstrate that variance explained using multiple question frames was similar to using only one. We detected a strong overarching factor for each instrument, with little variances left to be explained by the question frame. Therefore, it is unlikely that using different adverbial phrasings can help clinicians and researchers to improve their ability to detect depression or anxiety. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Potential of Reusing 3D Printed Concrete (3DPC) Fine Recycled Aggregates as a Strategy towards Decreasing Cement Content in 3DPC.

This paper explores the new potential strategy of using fine recycled aggregates (fRA) derived from waste 3D printed concrete (3DPC) as a substitute for cement in additive manufacturing. This study hypothesizes that fRA can optimize mixture design, reduce cement content, and contribute to sustainable construction practices. Experimental programs were conducted to evaluate the fresh and hardened properties, printability window, and buildability of 3DPC mixes containing fRA. Mixes with replacement rates of cement with fRA by 10 vol%, 20 vol%, 30 vol%, 40 vol%, and 50 vol% were produced. A comprehensive experimental protocol consisting of rheological studies (static and dynamic yield stress), dynamic elastic modulus determination (first 24 h of hydration), flexural and compressive strengths (2 d and 28 d), and an open porosity test was performed. The obtained results were verified by printing tests. In addition, an economic and environmental life cycle assessment (LCA) of the mixes was performed. The results indicate that up to 50 vol% cement replacement with fRA is feasible, albeit with some technical drawbacks. While fRA incorporation enhances sustainability by reducing CO2 emissions and material costs, it adversely affects the printability window, green strength, setting time, and mechanical properties, particularly in the initial curing stages. Therefore, with higher replacement rates (above 20 vol%), potential optimization efforts are needed to mitigate drawbacks such as reduced green strength and buildability. Notably, replacement rates of up to 20 vol% can be successfully used without compromising the overall material properties or altering the mixture design. The LCA analysis shows that reducing the cement content and increasing the fRA addition results in a significant reduction in mix cost (up to 24%) and a substantial decrease in equivalent CO2 emissions (up to 48%). In conclusion, this study underscores the potential of fRA as a sustainable alternative to cement in 3D printed concrete.

The interplay between ADHD and school shift on educational outcomes in children and adolescents: A cross-sectional and longitudinal analysis.

Many countries implement a double-shift schooling system, offering morning or afternoon shifts, driven by diverse factors. Young people with ADHD may face educational problems attending morning shifts compared to afternoon shifts. To investigate this, we used data from a Brazilian school-based cohort (n = 2.240, 6-14 years old, 45.6% female; 50.2% in the morning shift; 11.2% with ADHD). ADHD was determined by child psychiatrists using semi-structured interview. Educational outcomes were measured cross-sectionally and three years later (80% retention) and included reading and writing ability, performance in school subjects, and any negative school events (repetition, suspension, or dropout). Generalized regression models tested the interaction between ADHD and school shift and were adjusted for age, sex, race/ethnicity, intelligence, parental education, socioeconomic status, and site. Attrition was adjusted with inverse probability weights. We used two dimensional measures of attentional problems as sensitivity analysis. ADHD and morning shift were independently associated with lower reading and writing ability and with higher odds for negative school events cross sectionally. ADHD independently predicted lower performance in school subjects and higher negative school events at follow-up. Interaction was found only at the cross-sectional level in a way that those studying in the afternoon present better educational outcomes compared with those studying in the morning only if they have lower ADHD symptom. Thus, ADHD was not associated with poorer educational outcomes among those studying in the morning. However, participants studying in the afternoon with lower levels of attentional problems presented better educational, despite these associations fade away over time.

How much or how often? Examining the screening properties of the DSM cross-cutting symptom measure in a youth population-based sample.

BACKGROUND: The DSM Level 1 Cross-Cutting Symptom Measure (DSM-XC) allows for assessing multiple psychopathological domains. However, its capability to screen for mental disorders in a population-based sample and the impact of adverbial framings (intensity and frequency) on its performance are unknown. METHODS: The study was based on cross-sectional data from the 1993 Pelotas birth cohort in Brazil. Participants with completed DSM-XC and structured diagnostic interviews (n = 3578, aged 22, 53.6% females) were included. Sensitivity, specificity, positive (LR+), and negative (LR-) likelihood ratios for each of the 13 DSM-XC domains were estimated for detecting five internalizing disorders (bipolar, generalized anxiety, major depressive, post-traumatic stress, and social anxiety disorders) and three externalizing disorders (antisocial personality, attention-deficit/hyperactivity, and alcohol use disorders). Sensitivities and specificities >0.75, LR+ > 2 and LR- < 0.5 were considered meaningful. Values were calculated for the DSM-XC's original scoring and for adverbial framings. RESULTS: Several DSM-XC domains demonstrated meaningful screening properties. The anxiety domain exhibited acceptable sensitivity and LR- values for all internalizing disorders. The suicidal ideation, psychosis, memory, repetitive thoughts and behaviors, and dissociation domains displayed acceptable specificity for all disorders. Domains also yielded small but meaningful LR+ values for internalizing disorders. However, LR+ and LR- values were not generally meaningful for externalizing disorders. Frequency-framed questions improved screening properties. CONCLUSIONS: The DSM-XC domains showed transdiagnostic screening properties, providing small but meaningful changes in the likelihood of internalizing disorders in the community, which can be improved by asking frequency of symptoms compared to intensity. The DSM-XC is currently lacking meaningful domains for externalizing disorders.

An Uncommon Presentation of Secondary Syphilis.

Syphilis is a chronic venereal disease caused by Treponema pallidum (TP). Destructive arthritis is rare in its primary and secondary stages but can occur in the tertiary stage and its congenital form.

Analysis of atorvastatin in environmental waters: Validation of an electrochemical molecularly imprinted polymer sensor with application of life cycle assessment.

The widespread presence of pharmaceuticals in wastewater effluents after treatment stands as a significant challenge faced in the field of wastewater management and public health. Governments and the scientific community have worked to meet this urgent need for effective solutions. Nevertheless, the development of detection strategies for pharmaceutical monitorization capable of delivering rapid, on-site, and sensitive responses remains an ongoing necessity. In this work, the performance of a previously developed molecularly imprinted polymer (MIP) based electrochemical sensor for detecting atorvastatin (ATV) in wastewater effluents and surface waters is presented. A simple preconcentration method followed by electrochemical measurements by differential pulse voltammetry (DPV) in 0.1 M phosphate buffer (pH = 7), was implemented. The analytical results were validated with those obtained on a set of 16 water samples by ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). Additionally, a life cycle assessment (LCA) was conducted to compare the environmental impact of both methodologies. The results obtained demonstrated that ATV detection using MIP-sensor was reliable when compared to the results found by UHPLC-MS/MS presenting a robust linear correlation coefficient of 0.843. The LCA results show that the novel MIP-sensor technique has lower associated environmental impacts than UHPLC-MS/MS, when the current analytical protocol for pharmaceuticals detection is applied. These findings highlight the potential of the developed MIP-sensor as an eco-friendly analytical tool for routine analysis and point-of-care monitoring of ATV in WWTP wastewater and surface water samples.

Comparison of diuretics and fluid expansion in the initial treatment of patients with normotensive acute pulmonary embolism: a systematic review and meta-analysis.

BACKGROUND: Right ventricular (RV) dysfunction is the main cause of death in patients with normotensive acute pulmonary embolism (PE). The optimal management for this subset of patients remains uncertain. This systematic review and meta-analysis focused on the comparison of diuretics and fluid expansion in patients with acute PE presenting with RV dysfunction and haemodynamic stability. METHODS: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines considering only RTCs. The authors searched the traditional and grey literature through 1 November 2022. Meta-analysis used open source packages in R. Inverse variance fixed-effects models with OR as the effect measure were used for primary analyses. The main outcomes defined in this review protocol included pulmonary arterial systolic pressure (PASP), creatinine value changes and N-terminal pro-B-type natriuretic peptide during the first 24 hours. RESULTS: Four studies with a total of 452 patients met the inclusion criteria. The baseline characteristics of patients were similar across all studies. Overall, patients receiving diuretics had a significant 24 hours reduction in pro-B-type natriuretic peptide (standard mean difference of -41.97; 95% CI -65.79 to -18.15), and PASP (standard mean difference of -5.96; 95% CI -8.06 to -3.86). This group had significantly higher creatinine levels (standard mean difference of 7.74; 95% CI 5.04 to 10.45). The quality of the studies was heterogeneous; two had a low risk of bias, and the other two had a high risk of bias. CONCLUSIONS: Very few studies have compared the efficacy and safety of diuretics and fluid expansion in normotensive patients with acute PE with RV failure. Overall, furosemide appears to reduce RV dysfunction in this subset of patients compared with fluid expansion. Further research is required to confirm these findings.

Proteomics Reveals mRNA Regulation and the Action of Annexins in Thyroid Cancer.

Differentiated thyroid cancer is the most common malignancy of the endocrine system. Although most thyroid nodules are benign, given the high incidence of thyroid nodules in the population, it is important to understand the differences between benign and malignant thyroid cancer and the molecular alterations associated with malignancy to improve detection and signal potential diagnostic, prognostic, and therapeutic targets. Proteomics analysis of benign and malignant human thyroid tissue largely revealed changes indicating modifications in RNA regulation, a common cancer characteristic. In addition, changes in the immune system and cell membrane/endocytic processes were also suggested to be involved. Annexin A1 was considered a potential malignancy biomarker and, similarly to other annexins, it was found to increase in the malignant group. Furthermore, a bioinformatics approach points to the transcription factor Sp1 as being potentially involved in most of the alterations seen in the malignant thyroid nodules.

Electrochemical Chemically Based Sensors and Emerging Enzymatic Biosensors for Antidepressant Drug Detection: A Review.

Major depressive disorder is a widespread condition with antidepressants as the main pharmacological treatment. However, some patients experience concerning adverse reactions or have an inadequate response to treatment. Analytical chromatographic techniques, among other techniques, are valuable tools for investigating medication complications, including those associated with antidepressants. Nevertheless, there is a growing need to address the limitations associated with these techniques. In recent years, electrochemical (bio)sensors have garnered significant attention due to their lower cost, portability, and precision. Electrochemical (bio)sensors can be used for various applications related to depression, such as monitoring the levels of antidepressants in biological and in environmental samples. They can provide accurate and rapid results, which could facilitate personalized treatment and improve patient outcomes. This state-of-the-art literature review aims to explore the latest advancements in the electrochemical detection of antidepressants. The review focuses on two types of electrochemical sensors: Chemically modified sensors and enzyme-based biosensors. The referred papers are carefully categorized according to their respective sensor type. The review examines the differences between the two sensing methods, highlights their unique features and limitations, and provides an in-depth analysis of each sensor.

Influência da composição corporal durante a hospitalização sobre a função pulmonar e força da musculatura inspiratória em pacientes com COVID-19: estudo transversal / Influence of body composition during hospitalization on lung function and inspiratory muscle strength in patients with COVID19: cross-sectional study

Introdução: Cerca de 31% dos pacientes hospitalizados com COVID-19 perdem mais de 5% de seu peso inicial, levando a fraqueza muscular. Portanto, a composição corporal tornou-se foco de investigação, para estimar comprometimento pulmonar, força da musculatura inspiratória e mortalidade. Objetivos: Investigar se a perda de peso e a composição corporal de pacientes internados com COVID-19 influenciam na função pulmonar e na força muscular inspiratória após alta hospitalar. Métodos: Estudo transversal. Pacientes adultos foram avaliados após internação por COVID-19. Os desfechos avaliados foram função pulmonar, pressão inspiratória máxima (Pimáx), composição corporal e mortalidade. As correlações entre as variáveis foram estimadas pelo Coeficiente de Correlação de Pearson. Resultados: A capacidade Vital Forçada (CVF) foi correlacionada com perda de peso, massa muscular esquelética, massa magra, perna esquerda e massa livre de gordura; o volume expiratório forçado no primeiro segundo (VEF1) correlacionou-se apenas com a perda de peso; e a Pimáx foi correlacionada com massa muscular esquelética, massa magra, perna esquerda, perna direita e massa livre de gordura. Conclusão: Observou-se correlação moderada entre CVF e as variáveis de composição corporal analisadas, exceto massa magra da perna esquerda; entre VEF1 e perda de peso; e entre Pimáx e as variáveis de composição corporal analisadas, exceto perda de peso.

Translation, cultural adaptation, and validation of the Brazilian Portuguese version of the Higher Education Stress Inventory (HESI-Br).

OBJECTIVES: There are no validated instruments to measure education-related stress in Brazilian university students. Thus, we aimed to translate and test the internal reliability, convergent/discriminant validity, and measurement equivalence of the Higher Education Stress Inventory (HESI). METHODS: The translation protocol was carried out by two independent translators. The instrument was culturally adapted after a pilot version was administered to 36 university students. The final version (HESI-Br) was administered to 1,021 university students (mean age = 28.3, standard deviation [SD] = 9.6, 76.7% female) via an online survey that lasted from September 1 to October 15, 2020. The factor structure was estimated using exploratory factor analysis (EFA) on the first half of the dataset. We tested the best EFA-derived model with confirmatory factor analysis (CFA) on the second half. Convergent/discriminant validity was tested using the Depression, Anxiety and Stress Scale (DASS-21). Sex, age groups, period of study, family income and area of study were used to test measurement equivalence. RESULTS: EFA suggested five factors: career dissatisfaction; faculty shortcomings; high workload; financial concerns; and toxic learning environment. CFA supported the five-factor model (15 items), but not a higher order factor, suggesting multidimensionality. All five factors presented acceptable internal reliabilities, with Cronbach's α ≥ 0.72 and McDonald's ω ≥ 0.64. CFA models indicated that the HESI-Br and DASS-21 assess different but correlated underlying latent constructs, supporting discriminant validity. Equivalence was ascertained for all tested groups. CONCLUSION: The 15-item HESI-Br is a reliable and invariant multidimensional instrument for assessing relevant stressors among university students in Brazil.

Translation, cultural adaptation, and validation of the Brazilian Portuguese version of the Higher Education Stress Inventory (HESI-Br)

Abstract Objectives There are no validated instruments to measure education-related stress in Brazilian university students. Thus, we aimed to translate and test the internal reliability, convergent/discriminant validity, and measurement equivalence of the Higher Education Stress Inventory (HESI). Methods The translation protocol was carried out by two independent translators. The instrument was culturally adapted after a pilot version was administered to 36 university students. The final version (HESI-Br) was administered to 1,021 university students (mean age = 28.3, standard deviation [SD] = 9.6, 76.7% female) via an online survey that lasted from September 1 to October 15, 2020. The factor structure was estimated using exploratory factor analysis (EFA) on the first half of the dataset. We tested the best EFA-derived model with confirmatory factor analysis (CFA) on the second half. Convergent/discriminant validity was tested using the Depression, Anxiety and Stress Scale (DASS-21). Sex, age groups, period of study, family income and area of study were used to test measurement equivalence. Results EFA suggested five factors: career dissatisfaction; faculty shortcomings; high workload; financial concerns; and toxic learning environment. CFA supported the five-factor model (15 items), but not a higher order factor, suggesting multidimensionality. All five factors presented acceptable internal reliabilities, with Cronbach's α ≥ 0.72 and McDonald's ω ≥ 0.64. CFA models indicated that the HESI-Br and DASS-21 assess different but correlated underlying latent constructs, supporting discriminant validity. Equivalence was ascertained for all tested groups. Conclusion The 15-item HESI-Br is a reliable and invariant multidimensional instrument for assessing relevant stressors among university students in Brazil.

Peptidomics Unveils Distinct Acetylation Patterns of Histone and Annexin A1 in Differentiated Thyroid Cancer.

Thyroid cancer is a common malignancy of the endocrine system. Nodules are routinely evaluated for malignancy risk by fine needle aspiration biopsy (FNAB), and in cases such as follicular lesions, differential diagnosis between benign and malignant nodules is highly uncertain. Therefore, the discovery of new biomarkers for this disease could be helpful in improving diagnostic accuracy. Thyroid nodule biopsies were subjected to a precipitation step with both the insoluble and supernatant fractions subjected to proteome and peptidome profiling. Proteomic analysis identified annexin A1 as a potential biomarker of thyroid cancer malignancy, with its levels increased in malignant samples. Also upregulated were the acetylated peptides of annexin A1, revealed by the peptidome analysis of the supernatant fraction. In addition, supernatant peptidomic analysis revealed a number of acetylated histone peptides that were significantly elevated in the malignant group, suggesting higher gene transcription activity in malignant tissue. Two of these peptides were found to be robust malignancy predictors, with an area under the receiver operating a characteristic curve (ROC AUC) above 0.95. Thus, this combination of proteomics and peptidomics analyses improved the detection of malignant lesions and also provided new evidence linking thyroid cancer development to heightened transcription activity. This study demonstrates the importance of peptidomic profiling in complementing traditional proteomics approaches.

Late Recurrence of Pancreatic Solid Pseudopapillary Neoplasm With Peritoneal Carcinomatosis Treated With Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): A Case Report.

Pancreatic solid pseudopapillary neoplasm (SPN) is a rare malignant tumour predominantly affecting young women. The occurrence of peritoneal carcinomatosis (PC) in this setting is an even rarer condition, usually related to perioperative tumour rupture. We present a case of a 43-year-old woman who previously underwent distal splenopancreatectomy after the diagnosis of a pancreatic SPN. Thirteen years later, the patient underwent a radical hysterectomy due to a uterine myoma. Intraoperatively, a peritoneal mass was additionally found and resected. Histological examination revealed an implant with morphology compatible with pancreatic SPN. The patient was then referred to our institution. Staging MRI and CT revealed multiple nodular lesions adjacent to the left colon, suggestive of peritoneal implants. The patient was then submitted to cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) with oxaliplatin and irinotecan. Histological examination confirmed peritoneal involvement by a pancreatic SPN. The postoperative course was unremarkable. Two years after surgery, the patient remains asymptomatic with no evidence of relapse. Despite SPN being cancer with a relatively indolent evolution, one needs to be aware of a possible recurrence several years after the primary resection, mainly in patients with evidence of intraoperative tumour rupture.

Not all liver tumors are alike - an accidentally discovered primary hepatic leiomyosarcoma: A case report.

BACKGROUND: Primary hepatic leiomyosarcoma is a very rare entity that originates from smooth muscle. Preoperative diagnosis requires a high degree of suspicion due to atypical clinical presentation and non-specific imaging features. CASE SUMMARY: We report the case of a 42-year-old man, with no relevant past medical history, accidentally diagnosed with a nodular liver lesion on a routine abdominal ultrasound. Liver function tests and hematology parameters as well as tumor markers were normal. A contrast-enhanced abdominal computed tomography scan revealed a heterogenous hepatic lesion measuring 40 mm 30 mm, adjacent to the left branch of the portal vein and the round ligament. Due to the unclear diagnosis, the patient underwent surgical resection. Histopathological and immunohistochemical examinations confirmed complete (R0) resection of a hepatic leiomyosarcoma. The patient remains without any signs of tumor recurrence for more than 2 years. CONCLUSION: We report a rare case of accidentally diagnosed primary hepatic leiomyosarcoma originating from the portal vein or the round ligament. Although this tumor has aggressive metastatic potential, a tumor-free resection margin is essential to improve survival.