Early EEG and NIRS measurements in preterm babies: a systematic review.

Preterm birth represents a public health problem, with prematurity being the leading cause of infant mortality. An objective brain maturation and oxygenation measurement are necessary. The objective has been To test the feasibility of EEG and NIRS combination in the assessment of physiological brain maturation and oxygenation in preterm and non-preterm babies. A systematic review in Pubmed, Web of Science, MEDLINE, Cochrane, Dialnet, CINAHL, Scopus, Lilacs and PEDro databases until December 2022 was developed. 598 registers were found, finally 5 of them reached the inclusion criteria. Two independent reviewers analyzed data and a third reviewer were available for discrepancies. All articles combined EEG and NIRS to assess brain oxygenation and maturation in healthy new-born babies. There is an agreement on the electrode's placement for EEG at P3 and P4; besides, these regions have been shown to be a development predictive area, as well as the frontoparietal region for the NIRS region and comparison between regions. There is little evidence about the physiological brain electrical activity and oxygenation without stimuli.Conclusion: EEG and NIRS have been useful to assess brain electrical activity and oxygenation in preterm and non-preterm. The combined measurement of these instruments could be essential in neurological disorders diagnosis or their sequels. Unfortunately, the heterogeneity of the results found prevents a consensus on which variables are the most appropriate for the assessment of this population. What is Known • Brain assessment could help clinicians to prevent sequels. • There is an agreement for EEG electrodes placement at P3 and P4 region. What is New • EEG and NIRS assessment are effective measurements for preterm babies. • P3 and P4 regions have shown to be a predictive area of development, as well as the frontoparietal region for NIRS assessment.

A method to predict space radiation biological effectiveness for non-cancer effects following intense Solar Particle Events.

In addition to the continuous exposure to cosmic rays, astronauts in space are occasionally exposed to Solar Particle Events (SPE), which involve less energetic particles but can deliver much higher doses. The latter can exceed several Gy in a few hours for the most intense SPEs, for which non-stochastic effects are thus a major concern. To identify adequate shielding conditions that would allow respecting the dose limits established by the various space agencies, the absorbed dose in the considered organ/tissue must be multiplied by the corresponding Relative Biological Effectiveness (RBE), which is a complex quantity depending on several factors including particle type and energy, considered biological effect, level of effect (and thus absorbed dose), etc. While in several studies only the particle-type dependence of RBE is taken into account, in this work we developed and applied a new approach where, thanks to an interface between the FLUKA Monte Carlo transport code and the BIANCA biophysical model, the RBE dependence on particle energy and absorbed dose was also considered. Furthermore, we included in the considered SPE spectra primary particles heavier than protons, which in many studies are neglected. This approach was then applied to the October 2003 SPE (the most intense SPE of solar cycle 23, also known as "Halloween event") and the January 2005 event, which was characterized by a lower fluence but a harder spectrum, i.e., with higher-energy particles. The calculation outcomes were then discussed and compared with the current dose limits established for skin and blood forming organs in case of 30-days missions. This work showed that the BIANCA model, if interfaced to a radiation transport code, can be used to calculate the RBE values associated to Solar Particle Events. More generally, this work emphasizes the importance of taking into account the RBE dependence on particle energy and dose when calculating equivalent doses.

Pseudoaneurisma de ventriculo esquerdo, aneurisma ventricular associado e trombose mural após iam: complicações triplas na era da intervenção coronária percutânea / Left ventricular pseudoaneurysm, associated ventricular aneurysm and mural thrombosis after MI: triple complications in the era of percutaneous coronary intervention

INTRODUÇÃO: O Pseudoaneurisma do ventrículo esquerdo (PSAVE), aneurisma de ventrículo esquerdo (VE) e trombo mural são ocorrências incomuns no infarto agudo do miocárdio (IAM), sendo o PSAVE uma complicação ainda mais rara, correspondendo a menos de 0,1% dos pacientes com diagnóstico de IAM e com alta letalidade. Decorrem de ruptura miocárdica por necrose e o tratamento definitivo cirúrgico modifica o curso natural da doença. RELATO DE CASO: Paciente masculino, 70 anos, com hipertensão e diabetes apresentou IAM com supradesnivelamento de ST (IAMCSST) de parede anterior, sem reperfusão e foi submetido à estratificação invasiva em outro serviço após 72 horas. Foi tratado com implante de Stent farmacológico na artéria descendente anterior. Procurou assistência médica após 2 meses devido a quadro de insuficiência cardíaca (IC). Realizado ecocardiograma transtorácico que evidenciou PSAVE, recebendo alta com orientação de procurar esta instituição. Nova ecocardiografia evidenciou fração de ejeção do VE de 22% e grande aneurisma da região apical do VE, trombo mural e PSAVE na região ínfero-apical. Recebeu manejo com inotrópico intravenoso e após melhora clínica foi encaminhado para aneurismectomia com reconstrução do VE roto e trombectomia. Recebeu alta da UTI com18 dias de pós-operatório. DISCUSSÃO: Complicações mecânicas decorrentes da rotura por necrose miocárdica estão associadas à elevada mortalidade e as apresentações tardias após o evento agudo são relatos de seleção natural e achados incidentais. São associadas à necessidade de tratamento cirúrgico, especialmente em casos agudos, quando a ruptura pode ser fatal em até 45% dos casos. Na fase crônica, os sintomas por vezes são inespecíficos, podendo se apresentar com IC, insuficiência mitral, embolia sistêmica e arritmias cardíacas. CONCLUSÃO: Até o presente momento, este representa o primeiro relato de caso de tripla ocorrência de complicações associadas à grande massa miocárdica necrótica na era contemporânea da intervenção coronária percutânea no Brasil. Reiteramos a relevância dos casos com IAMCSST serem tratados com reperfusão precoce, fator independente para redução de mortalidade e salvamento miocárdico, portanto com menor risco desenvolvimento dessas complicações em pacientes tratados com implante de stent coronario após IAM, porém associada à elevada morbimortalidade na fase aguda. Sua suspeição, diagnóstico precoce e tratamento cirúrgico são essenciais para um desfecho clínico favorável.

Influence of airborne particle abrasion on dentin bonding effectiveness of a 2-step universal adhesive.

OBJECTIVE: To determine the effect of airborne particle abrasion (APA) on micro-tensile bond strength (µTBS) to dentin using different air-abrasion/polishing powders. METHODS: The bonding effectiveness of G2 Bond Universal (G2B), used in etch-and-rinse (E&R) and self-etch mode (SE), was tested on bur-cut dentin and dentin air abraded/polished using six different powders (aluminum oxide 29 µm (AO29) and 53 µm (AO53), aluminum trihydroxide (AT), sodium bicarbonate (SB), sodium bicarbonate soft (SBsoft) and bioactive glass (BG); Velopex). Adhesive-composite resin specimens were immersed in distilled water at 37 °C for one week and cut into microspecimens. Half of the specimens were subjected to 50,000 thermocycles (aged). Immediate and aged µTBS to dentin were measured. Statistical analysis was performed using linear mixed-effects (LME) modeling (p < 0.05). RESULTS: Comparing the aged bond strengths to air-abraded/polished dentin with bur-cut dentin, pretreatment with SB and SBsoft in combination with G2B used in E&R mode, and BG air polishing in combination with both application modes (E&R, SE), resulted in a significantly higher bond strength. Dentin bond strength was only significantly lower when air abraded with AO29 and using G2B in SE mode. Aging did not significantly influence bond strength for both application modes (E&R, SE), except for AO29 and AT-treated dentin, where bond strengths decrea sed significantly using G2B in SE mode. In general, G2B reached significantly higher bond strengths on air-abraded/polished dentin in E&R mode than in SE mode. CONCLUSION: Air-abrasion/polishing did not impair dentin bond strength using G2B, except when dentin was air abraded with AO29 and using G2B in SE mode. Air polishing positively influenced the bond strength to dentin in specific groups. CLINICAL SIGNIFICANCE: APA is safe concerning bonding to dentin. The E&R application mode is preferred using G2B as adhesive on air-abraded/polished dentin. Air polishing with BG positively influenced dentin bond strength for both application methods.

Diaspis echinocacti (Hemiptera: Diaspididae) on cactus pear cladodes: biological aspects at different temperatures.

The scale mealybug, Diaspis echinocacti (Bouché, 1833) (Hemiptera: Diaspididae), is one of the main pests of the cactus pear in Brazil. The objective was to study biological aspects of D. echinocacti at the constant temperatures of 25, 28, 30, 33 and 35 °C with relative humidity of 60 ± 10% and photoperiod of 12 hours in the laboratory on the cactus pear cultivar, "Orelha de Elefante Mexicana", Opuntia stricta [Haw.] Haw. The development period (22 to 35 days) and survival in the egg (92 to 100%) and nymph (21.8 to 100%) stages and of the egg-adult cycle (20 to 100%), longevity (34.1 to 59.6 days) and fecundity (33 to 112 eggs) of D. echinocacti females with the different temperature and absence of males at the highest temperatures (> 30°C), indicated that the range between 25 °C and 30°C is the most favorable for this scale mealybug. This information may help to improve integrated management programs for D. echinocacti, in areas subject to seasonal temperature changes in the Brazilian regions where cactus pear is cultivated.

Recombinant human TIM-3 ectodomain expressed in bacteria and recovered from inclusion bodies as a stable and active molecule.

Introduction: Microbial systems, such as Escherichia coli, as host recombinant expression is the most versatile and the cheapest system for protein production, however, several obstacles still remain, such as recovery of soluble and functional proteins from inclusion bodies, elimination of lipopolysaccharides (LPS) contamination, incomplete synthesis, degradation by proteases, and the lack of post-translational modifications, which becomes even more complex when comes to membrane proteins, because they are difficult not only to produce but also to keep in solution in its active state. T-cell Immunoglobulin and Mucin domain 3 (TIM-3) is a type I transmembrane protein that is predominantly expressed on the surface of T lymphocytes, natural killer (NK) cells, dendritic cells, and macrophages, playing a role as a negative immune checkpoint receptor. TIM-3 comprises a single ectodomain for interaction with immune system soluble and cellular components, a transmembrane domain, and a cytoplasmic tail, responsible for the binding of signaling and scaffolding molecules. TIM-3 pathway holds potential as a therapeutic target for immunotherapy against tumors, autoimmunity, chronic virus infections, and various malignancies, however, many aspects of the biology of this receptor are still incompletely understood, especially regarding its ligands. Methods: Here we overcome, for the first time, the challenge of the production of active immune checkpoint protein recovered from bacterial cytoplasmic inclusion bodies, being able to obtain an active, and non-glycosylated TIM-3 ectodomain (TIM-3-ECD), which can be used as a tool to better understand the interactions and roles of this immune checkpoint. The TIM-3 refolding was obtained by the association of high pressure and alkaline pH. Results: The purified TIM-3-ECD showed the correct secondary structure and was recognized from anti-TIM-3 structural-dependent antibodies likewise commercial TIM-3-ECD was produced by a mammal cells system. Furthermore, immunofluorescence showed the ability of TIM-3-ECD to bind to the surface of lung cancer A549 cells and to provide an additional boost for the expression of the lymphocyte activation marker CD69 in anti-CD3/CD28 activated human PBMC. Discussion: Taken together these results validated a methodology able to obtain active checkpoint proteins from bacterial inclusion bodies, which will be helpful to further investigate the interactions of this and others not yet explored immune checkpoints.

Loss of POC and DOC on seagrass sediments by hydrodynamics.

Coastal development and climate change are sparking growing concern about the vulnerability of the organic carbon (OC) stocks in marine sediments to remineralization, especially in high threaten coastal ecosystems like seagrass meadows. Uncertainties still exist regarding the role played by hydrodynamics, seagrass canopies and sediment properties in OC resuspension and remineralization. A set of laboratory experiments were conducted to assess, for the first time, the mechanisms by which the particulate and dissolved organic carbon (POC and DOC) may be released and remineralized under hydrodynamic conditions (i.e., unidirectional and oscillatory flows) in two eelgrass densities and sediments properties (i.e., grain size and OC content). After a gradually increase in hydrodynamic forces, our results demonstrated that the presence of eelgrass reduced sediment erosion and OC loss in high-density canopies, while low-density canopies promote OC resuspension (on average, 1.8-fold higher than high-density canopies). We also demonstrated that unidirectional and oscillatory flows released similar DOC from surface sediments (on average, 15.5 ± 1.4 and 18.4 ± 1.8 g m-2, respectively), whereas oscillatory flow released significantly more POC than unidirectional flows (from 10.8 ± 1.1 to 32.1 ± 5.6 g m-2 for unidirectional and oscillatory flows, respectively). POC and DOC released was strongly influenced by both seagrass meadow structure (i.e., lower eelgrass density and shoot area) and sediment properties (i.e., lower mud and higher sediment water content). We found that, although >74 % of OC in upper sediments was remineralized within 30 days, a relatively high amount of OC in high-density canopies is recalcitrant, highlighting its potential for the formation of blue carbon deposits. This study highlights the vulnerability of OC deposits in seagrass sediments to resuspension if the meadow is degraded and/or the climate change yield stronger storms, which could potentially weaken the seagrass meadows' service as blue carbon ecosystem in the future.

Clinical utility of a personalized and long-term monitoring device for Parkinson's disease in a real clinical practice setting: An expert opinion survey on STAT-ON™.

BACKGROUND: STAT-ON™ is an objective tool that registers ON-OFF fluctuations making possible to know the state of the patient at every moment of the day in normal life. Our aim was to analyze the opinion of different Parkinson's disease experts about the STAT-ON™ tool after using the device in a real clinical practice setting (RCPS). METHODS: STAT-ON™ was provided by the Company Sense4Care to Spanish neurologists for using it in a RCPS. Each neurologist had the device for at least three months and could use it in PD patients at his/her own discretion. In February 2020, a survey with 30 questions was sent to all participants. RESULTS: Two thirds of neurologists (53.8% females; mean age 44.9±9 years old) worked in a Movement Disorders Unit, the average experience in PD was 16±6.9 years, and 40.7% of them had previously used other devices. A total of 119 evaluations were performed in 114 patients (range 2-9 by neurologist; mean 4.5±2.3). STAT-ON™ was considered "quite" to "very useful" by 74% of the neurologists with an overall opinion of 6.9±1.7 (0, worst; 10, best). STAT-ON™ was considered better than diaries by 70.3% of neurologists and a useful tool for the identification of patients with advanced PD by 81.5%. Proper identification of freezing of gait episodes and falls were frequent limitations reported. CONCLUSION: STAT-ON™ could be a useful device for using in PD patients in clinical practice.

Palliative care management in patients with Parkinson's disease and other movement disorders in Spain. National survey of neurologists.

INTRODUCTION: Palliative care in neurodegenerative diseases is useful but underused. The objective of this study is to know how palliative care (PC) is applied in Spain in order to identify limitations and unmet needs. MATERIALS AND METHODS: It is a descriptive, observational, cross-sectional study, anonymous survey type of 20 questions, directed and answered by neurologists dedicated to movement disorders (MD) in Spain. RESULTS: 58 responses were obtained from neurologists from 15 autonomous communities. 69% answered that they did not have a specialised MD nursing facility but did have a PC team in their centre (81%). No specific protocol for PC in MD was identified. All except one neurologist stated that they lacked sufficient training in PC, the main training need being the "advance directives explanation". Only 1 in 4 neurologists answered routinely explaining advance healthcare planning to their patients, recognising up to 84.5% of neurologists not knowing how to assess the patient's competence. 60.3% of those surveyed answered that between 10% and 30% of their patients would be candidates for PC, although 1 in 3 said they were not clear when to refer the patient to PC. 100% of neurologists affirmed the priority need to implement PC protocols in MD. CONCLUSIONS: Our study shows a formative deficit in PC in this area and in the care of the patient with movement disorders and their environment, and should serve as a starting point to develop consensual care protocols.

Emission of coherent THz magnons in an antiferromagnetic insulator triggered by ultrafast spin-phonon interactions.

Antiferromagnetic materials have been proposed as new types of narrowband THz spintronic devices owing to their ultrafast spin dynamics. Manipulating coherently their spin dynamics, however, remains a key challenge that is envisioned to be accomplished by spin-orbit torques or direct optical excitations. Here, we demonstrate the combined generation of broadband THz (incoherent) magnons and narrowband (coherent) magnons at 1 THz in low damping thin films of NiO/Pt. We evidence, experimentally and through modeling, two excitation processes of spin dynamics in NiO: an off-resonant instantaneous optical spin torque in (111) oriented films and a strain-wave-induced THz torque induced by ultrafast Pt excitation in (001) oriented films. Both phenomena lead to the emission of a THz signal through the inverse spin Hall effect in the adjacent heavy metal layer. We unravel the characteristic timescales of the two excitation processes found to be < 50 fs and > 300 fs, respectively, and thus open new routes towards the development of fast opto-spintronic devices based on antiferromagnetic materials.

Fracture Load of Molars Restored with Bulk-fill, Flowable Bulk-fill, and Conventional Resin Composite After Simulated Chewing.

This study aimed to compare the fracture toughness of molars with wide mesio-occlusal-distal (MOD) cavities restored with regular and flowable bulk-fill resin composite and a conventional resin composite after 250,000 mechanical cycles of chewing simulation. Thirty-two extracted mandibular third molars were selected and class II MOD cavities involving 2/3 of the intercuspal width and 4 mm depth were prepared. Teeth were divided into four groups based on resin composite type and insertion technique (n=8): (1) CT, unprepared teeth (control); (2) CV, conventional resin composite (Tetric N-Ceram, Ivoclar Vivadent) with incremental technique; (3) R-BF, regular bulk-fill resin composite (Tetric N-Ceram Bulk Fill, Ivoclar Vivadent) with a single increment; and (4) F-BF, flowable bulk-fill resin composite (Tetric N-Flow Bulk Fill, Ivoclar Vivadent) with a single increment, except for a 1-mm-thick layer at the occlusal surface, restored with conventional resin composite (Tetric N-Ceram). All specimens were evaluated to detect the presence and propagation of enamel cracks using a LED transilluminator before and after 250,000 mechanical cycles (SD Mechatronic GmbH). After a chewing simulation, they were subjected to a compressive force in a universal testing machine (DL-2000, EMIC) until fracture. The maximum fracture load of the specimens was measured (N) and the fracture patterns were classified based on the fracture site (above or below the cementoenamel junction [CEJ]). Data were statistically analyzed with one-way ANOVA. All specimens survived after 250,000 mechanical cycles, and no statistically significant differences among groups were observed regarding the fracture toughness (p<0.05). The fracture analysis demonstrated that failures below the CEJ were more common in CV (75%), while CT, R-BF, and F-BF showed this type of failure in 38%, 63%, and 63% of the specimens, respectively. The results of the crack analysis showed that the occurrence of new cracks and crack propagation was also higher in CV (33.3%), followed by R-BF, F-BF, and CT (14%, 14%, and 11% of the specimens, respectively). Teeth restored with regular and flowable bulk-fill composites showed similar fracture toughness after the chewing simulation compared to those restored with the conventional resin composite and unprepared teeth. Furthermore, teeth restored with both regular and flowable bulk-fill composites showed a lower incidence of enamel cracks and fractures below the CEJ compared to those restored with the conventional resin composite.

Contribution of halloysite as nanotubular clay mineral on mechanism and adsorption rate of Cd(II) onto nanocomposites alginate-halloysite.

In this work nanocomposites based on alginate (Alg) and halloysite as a nanotubular clay (Hy) were developed. Characterization techniques reveal that Hy/Alg nanocomposites are cation exchangers with predominantly negative charge density and good thermal stability. The adsorption equilibrium of Cd(II) in aqueous solution onto Hy/Alg nanocomposites revealed that by increasing the mass of halloysite in the nanocomposite, the adsorption capacity diminished significantly due to the halloysite-alginate interactions. Maximum adsorption capacities of 8, 65, 88, and 132 mg/g of Cd(II) were obtained for samples Hy, Hy/Alg 50%, Hy/Alg 95%, and Alg, respectively. In addition, the adsorption equilibrium of Cd(II) on the Hy/Alg bionanocomposites was affected by the pH and temperature of the solution, demonstrating the presence of electrostatic interactions during adsorption and that this is an exothermic process. The controlling mechanism of adsorption was cation exchange influenced by electrostatic forces. The Cd(II) adsorption rate studies were interpreted by the diffusion-permeation model and reveal that the presence of Hy in the structure of the nanocomposites enhances the permeation coefficient, that is, the adsorption rate was increased. The values of the permeation coefficient varied from 1.95 × 10-7 to 8.50 × 10-7 cm2/s for Hy/Alg 50% and from 1.70 × 10-7 to 3.55 × 10-7 cm2/s for Hy/Alg 95%.

Recombinant human TIM-3 ectodomain expressed in bacteria and recovered from inclusion bodies as a stable and active molecule

Introduction: Microbial systems, such as Escherichia coli, as host recombinant expression is the most versatile and the cheapest system for protein production, however, several obstacles still remain, such as recovery of soluble and functional proteins from inclusion bodies, elimination of lipopolysaccharides (LPS) contamination, incomplete synthesis, degradation by proteases, and the lack of post-translational modifications, which becomes even more complex when comes to membrane proteins, because they are difficult not only to produce but also to keep in solution in its active state. T-cell Immunoglobulin and Mucin domain 3 (TIM-3) is a type I transmembrane protein that is predominantly expressed on the surface of T lymphocytes, natural killer (NK) cells, dendritic cells, and macrophages, playing a role as a negative immune checkpoint receptor. TIM-3 comprises a single ectodomain for interaction with immune system soluble and cellular components, a transmembrane domain, and a cytoplasmic tail, responsible for the binding of signaling and scaffolding molecules. TIM-3 pathway holds potential as a therapeutic target for immunotherapy against tumors, autoimmunity, chronic virus infections, and various malignancies, however, many aspects of the biology of this receptor are still incompletely understood, especially regarding its ligands. Methods: Here we overcome, for the first time, the challenge of the production of active immune checkpoint protein recovered from bacterial cytoplasmic inclusion bodies, being able to obtain an active, and non-glycosylated TIM-3 ectodomain (TIM-3-ECD), which can be used as a tool to better understand the interactions and roles of this immune checkpoint. The TIM-3 refolding was obtained by the association of high pressure and alkaline pH. Results: The purified TIM-3-ECD showed the correct secondary structure and was recognized from anti-TIM-3 structural-dependent antibodies likewise commercial TIM-3-ECD was produced by a mammal cells system. Furthermore, immunofluorescence showed the ability of TIM-3-ECD to bind to the surface of lung cancer A549 cells and to provide an additional boost for the expression of the lymphocyte activation marker CD69 in anti-CD3/CD28 activated human PBMC. Discussion: Taken together these results validated a methodology able to obtain active checkpoint proteins from bacterial inclusion bodies, which will be helpful to further investigate the interactions of this and others not yet explored immune checkpoints.

Emerging Evidence on the Use of Probiotics and Prebiotics to Improve the Gut Microbiota of Older Adults with Frailty Syndrome: A Narrative Review.

BACKGROUND: The gut microbiota can impact older adults' health, especially in patients with frailty syndrome. Understanding the association between the gut microbiota and frailty syndrome will help to explain the etiology of age-related diseases. Low-grade systemic inflammation is a factor leading to geriatric disorders, which is known as "inflammaging". Intestinal dysbiosis has a direct relationship with low-grade systemic inflammation because when the natural gut barrier is altered by age or other factors, some microorganisms or their metabolites can cross this barrier and reach the systemic circulation. OBJECTIVES: This review had two general goals: first, to describe the characteristics of the gut microbiota associated with age-related diseases, specifically frailty syndrome. The second aim was to identify potential interventions to improve the composition and function of intestinal microbiota, consequently lessening the burden of patients with frailty syndrome. METHODS: A search of scientific evidence was performed in PubMed, Science Direct, and Redalyc using keywords such as "frailty", "elderly", "nutrient interventions", "probiotics", and "prebiotics". We included studies reporting the effects of nutrient supplementation on frailty syndrome and older adults. These studies were analyzed to identify novel therapeutic alternatives to improve gut microbiota characteristics as well as subclinical signs related to this condition. RESULTS: The gut microbiota participates in many metabolic processes that have an impact on the brain, muscles, and other organs. These processes integrate feedback mechanisms, comprising their respective axis with the intestine and the gut microbiota. Alterations in these associations can lead to frailty. We report a few interventions that demonstrate that prebiotics and probiotics could modulate the gut microbiota in humans. Furthermore, other nutritional interventions could be used in patients with frailty syndrome. CONCLUSION: Probiotics and prebiotics may potentially prevent frailty syndrome or improve the quality of life of patients with this disorder. However, there is not enough information about their appropriate doses and periods of administration. Therefore, further investigations are required to determine these factors and improve their efficacy as therapeutic approaches for frailty syndrome.

Identifying a victim of alligator attack and scavenger fish in the Brazilian Amazon rainforest using smile photographs: a case report.

Reports of deaths caused by alligators or crocodiles are rare in the literature. These deaths may be related to sharp force trauma caused by the teeth of these animals, with or without mutilation, or even drowning after seizure and submersion of the victim. It is difficult to forensically identify bodies in cases of mutilation of the upper limbs during the attack or when the corpse is in an advanced stage of skeletonization. Smile photographs are an important source of ante-mortem references for comparison. We report a human identification based on a photograph of a victim, with the absence of limbs caused by an alligator attack and the advanced skeletonization stage due to scavenger fish action in the Amazon within only 36 hours after his disappearance. The description of alligator attacks and the marks observed on the victim's body are essential to help medical and forensic professionals diagnose the injuries found and, consequently, define the cause of death.

[Adaptation and feasibility of the online version of the Fugl Meyer scale for the assessment of patients following cerebrovascular accidents. Reply]. / Comentario al original 'Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares. Réplica.

TITLE: Comentario al original 'Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares. Réplica.

Carbon metabolism and bioavailability of dissolved organic carbon (DOC) fluxes in seagrass communities are altered under the presence of the tropical invasive alga Halimeda incrassata.

Seagrass beds act as blue carbon sinks globally as they enhance the trapping of recalcitrant (i.e., low biodegradability) organic carbon in their sediments. Recent studies also show that the recalcitrant fraction of the dissolved organic carbon (DOC) pool in seawater has an important role as long-term carbon sequestration in oceans. Although seagrasses are known for the large amount of DOC they export, little attention has been given to its biodegradability, which ultimately determinates its fate in the coastal carbon cycle. In turn, invasive algae are a major global concern in seagrass ecosystems since they can deeply modify their structure and functions, which may affect carbon metabolism and DOC release. This work assesses how the presence of Halimeda incrassata, an invasive tropical calcareous macroalga, modifies carbon metabolism and DOC fluxes in invaded areas dominated by the seagrass Cymodocea nodosa. Our results show that stands with the presence of this seagrass (i.e., both monospecific and mixed meadow) had the highest production values, acting as high DOC producers in both winter (mainly of labile DOC; DOCL) and summer (mainly as recalcitrant DOC; DOCR). In contrast, monospecific H. incrassata beds exhibited low production values, and the presence of this macroalga (either as monospecific beds or mixed with C. nodosa) triggered the shift from a net DOC-producing-system in summer (mainly DOCL) to a net DOC-consuming-system in winter. This work thus suggests that C. nodosa meadows have the potential to export a significant fraction of both labile and recalcitrant DOC, and that the spread of this invasive alga might decrease the C export capacity of seagrass meadows. Such shift would imply the reduction of a quick and efficient transfer of carbon and energy to higher trophic levels, and might reduce the blue carbon potential of seagrasses as dissolved form in the water column.

Autosomal recessive spinocerebellar ataxia SCAR8/ARCA1: first families detected in Spain.

INTRODUCTION: Autosomal recessive spinocerebellar ataxia type 8 (ARCA1/SCAR8) is caused by mutations of the SYNE1 gene. The disease was initially described in families from Quebec (Canada) with a phenotype of pure cerebellar syndrome, but in recent years has been reported with a more variable clinical phenotype in other countries. Cases have recently been described of muscular dystrophy, arthrogryposis, and cardiomyopathy due to SYNE1 mutations. OBJECTIVE: To describe clinical and molecular findings from 4 patients (3 men and one woman) diagnosed with ARCA1/SCAR8 from 3 Spanish families from different regions. MATERIAL AND METHODS: We describe the clinical, paraclinical, and genetic results from 4 patients diagnosed with ARCA1/SCAR8 at different Spanish neurology departments. RESULTS: Onset occurred in the third or fourth decade of life in all patients. After 15 years of progression, 3 patients presented pure cerebellar syndrome, similar to the Canadian patients; the fourth patient, with over 30 years' progression, presented vertical gaze palsy, pyramidal signs, and moderate cognitive impairment. In all patients, MRI studies showed cerebellar atrophy. The genetic study revealed distinct pathogenic SYNE1 mutations in each family. CONCLUSIONS: ARCA1/SCAR8 can be found worldwide and may be caused by many distinct mutations in the SYNE1 gene. The disease may manifest with a complex phenotype of varying severity.

Three-year Follow-up of Conservative Direct Composite Veneers on Eroded Teeth.

This clinical case describes an esthetic rehabilitation of a young patient presenting with erosive tooth wear. The etiological factors for the erosion in this clinical case was excessive carbonated beverages and lemon water intake. The patient's main complaint was the yellowish aspect of her smile. The treatment procedure selected was direct resin composite veneers in the six maxillary anterior teeth. A three-year follow-up of the case is presented. The three-year follow-up showed a successful clinical performance of the treatment procedure after a finishing/polishing protocol.

[Adaptation and feasibility of the online version of the Fugl Meyer scale for the assessment of patients following cerebrovascular accidents]. / Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares.

INTRODUCTION: Patients who have suffered a chronic cerebrovascular accident or a stroke need long-term physiotherapy treatments. However, they have had to be stopped due to the COVID-19 pandemic. To be able to offer these patients an online functional assessment, a proposal was put forward to design an adaptation of the Spanish version of the Fugl Meyer assessment scale and to test its viability. PATIENTS AND METHODS: The adapted online scale, based on the Fugl Meyer assessment scale. The motor function, balance and pain domains were kept, and items requiring assistance for the patient were removed. This scale was administered to 13 patients with a chronic cerebrovascular accident from the Salamanca Acquired Brain Injury Association (Asociacion de Dano Cerebral Adquirido) via different web platforms. The procedure followed was the same as for the original scale and lasted from 30 to 45 minutes. RESULTS: All the patients completed the Fugl Meyer assessment scale, online version. The greatest difficulty was encountered in the assessment of the lower limbs. Patients and physiotherapists highlighted how easy it was to complete the items in the scale. On comparing the versions, statistically significant positive correlations were found with the original version (p < 0.001) and the correlation coefficients indicated a strong association. The difference between the equivalent sections of the scale in each instrument was no greater than 5%, except for balance. CONCLUSION: The Fugl Meyer assessment scale, online version, is a feasible, useful and easy to apply scale that allows assessment of the functional status of stroke patients and can help meet the current needs during the COVID-19 pandemic.

TITLE: Adaptación y viabilidad de la versión telemática de la escala Fugl Meyer para la evaluación de pacientes tras accidentes cerebrovasculares.Introducción. Los pacientes que han sufrido un accidente cerebrovascular crónico o un ictus necesitan tratamientos de fisioterapia a largo plazo. Sin embargo, la pandemia de COVID-19 ha obligado a detenerlos. Con el objetivo de poder ofrecer una evaluación funcional de forma telemática a estos pacientes, se propuso diseñar una adaptación de la escala de evaluación Fugl Meyer-versión española y comprobar su viabilidad. Pacientes y métodos. Escala telemática adaptada, basada en la escala de evaluación Fugl Meyer. Se mantuvieron los dominios de función motora, equilibrio y dolor, y se eliminaron ítems que requerían ayuda para el paciente. Dicha escala se administró a 14 pacientes con accidente cerebrovascular crónico de la Asociación de Daño Cerebral Adquirido de Salamanca, a través de diferentes plataformas web, siguiendo el mismo procedimiento que la escala original y con una duración de 30 a 45 minutos. Resultados. Todos los pacientes completaron la escala de evaluación Fugl Meyer-versión telemática. La mayor dificultad se encontró para la evaluación de las extremidades inferiores. Los pacientes y los fisioterapeutas destacaron la facilidad de realización de los ítems de la escala. Al comparar las versiones se encontraron correlaciones positivas estadísticamente significativas con la versión original (p menor de 0,001) y los coeficientes de correlación indicaron una fuerte asociación. La diferencia entre las secciones de la escala equivalentes en cada instrumento no fue mayor que el 5%, excepto en el equilibrio. Conclusión. La escala de evaluación Fugl Meyer-versión telemática, es una escala viable, útil y fácil de aplicar que permite la evaluación del estado funcional de los pacientes con ictus y que puede responder a las necesidades actuales durante la pandemia de COVID-19.