Secular trends and sociodemographic, biological, and behavioural factors associated with handgrip strength in adolescents in southern Brazil: An allometric approach.

The purpose of this study was to analyse secular trend in handgrip strength (HGS) in adolescents using an allometric approach and identify the factors associated. The sample comprised 657 and 1004 adolescents (14 to 19 years) in 2007 and 2017/2018, respectively, of public schools in Florianópolis, Brazil. The dependent variable was HGS normalised to body mass and height. Covariance analysis was used to examine secular trends in HGS, and multiple linear regression was used to identify associated factors. The independent variables were sociodemographic, biological, and behavioural factors. Comparison of HGS between surveys indicated a negative secular trend in both sexes (p < 0.001). In boys, there was a positive association of HGS with age and FFM in both surveys. In 2017/18, there was a positive association with sexual maturation and a negative association with sitting time and fat percentage. In girls, FFM was positively associated with HGS in both surveys. In 2007, there were positive associations of HGS with age and vigorous physical activity, whereas, in 2017/18, negative associations were observed with economic level and sitting time. The findings of the present study show a decline in adolescent HGS. And behavioural changes appear to be contributing to declines in HGS.

Telemedicine in Post-Exposure Prophylaxis to Biological Material During the COVID-19 Pandemic: Impact on Care and Outcome Indicators.

Introduction: The restrictions on face-to-face care for exposure to biological material during the COVID-19 pandemic required alternatives to maintain outpatient assistance. This study evaluated the impact of telemedicine on care and outcome indicators of a reference service for exposure to biological material during the COVID-19 pandemic. Methods: This pre- and post-study compared the effectiveness of telemedicine in the Hospital Correia Picanço in Recife (Pernambuco, Brazil) before (August 2018 to January 2019 [P1]) and during the COVID-19 pandemic (August 2020 to January 2021 [P2]). Individuals above 18 years old exposed to biological material who sought the service during P1 or P2 were included in the study. Results: A total of 4,494 cases were assessed (1,997 in P1 and 2,497 in P2), mostly because of sexual exposure (62.3%). The mean age was 32.2 ± 9.2 years, most individuals were male (64.9%), originated from Recife (56.6%), and the education level was up to 12 years (53.7%). P2 presented 43% more attendances and shorter intervals between the exposure and first attendance (51%), first testing (28%), and discharge (10%) than P1 (p < 0.05), and cases had no difference in discharge rate (p = 0.339). Cases of sexual exposure had the highest dropout rate in both periods. Conclusion: Telemedicine maintained similar outcomes to face-to-face care and improved the indicators, increasing the mean monthly attendance and reducing the time between exposure and follow-up.

Association between cardiorespiratory fitness and low back pain is anxiety-dependent: A prospective cohort study among adults and older adults.

To investigate the relationship between low back pain and cardiorespiratory fitness (CRF) among participants with and without self-report anxiety. Participants were 13,080 individuals (86.6% men; 44.7 ± 9.3 years). CRF was quantified as maximal treadmill test duration and was grouped for analysis as low (lowest 20% of treadmill test duration), moderate (middle 40%), and high (upper 40%). Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) between low back pain and CRF according to the presence/absence of self-report anxiety. During an average of 5.7 ± 5.1 years of follow-up, 2,965 cases of low back pain were identified. Participants with self-report anxiety and low CRF had 3.7 times (HR: 3.7; 95%CI: 1.7-8.2) more risk for having low back pain when compared with participants with self-report anxiety and high CRF. Additionally, among participants with self-reported anxiety, moderate CRF was associated with an 70% greater risk of having low back pain than those with high CRF (HR: 1.7; 95%CI: 1.1-3.2). For participants without self-reported anxiety, no association was found between the risk of having low back pain and CRF. According to the results identified in the present study, participants with self-reported anxiety who had low and moderate CRF had higher risks of low back pain than those with high CRF.

Handgrip Strength Is Not Associated With High Blood Pressure and Does Not Have Good Discriminatory Power for High Blood Pressure in Adolescents.

ABSTRACT: de Lima, TR and Silva, DAS. Handgrip strength is not associated with high blood pressure and does not have good discriminatory power for high blood pressure in adolescents. J Strength Cond Res 37(1): 46-54, 2023-Muscle strength measured by handgrip strength (HGS) was inversely and independently associated with high blood pressure (HBP). In addition, HGS has been used as a valuable indicator for monitoring pediatric health. This study aimed to investigate the association between HGS indexes and HBP, verify the discriminatory capacity of HGS to identify HBP in adolescents, and propose cut-points for HGS to be used in the early identification of HBP if good discriminatory power is identified between the variables. This was a cross-sectional study comprising 811 adolescents (male: 48.9%; age: 16.4 ± 1.3 years) from southern Brazil. Blood pressure was measured by the oscillometric method. Handgrip strength was assessed by a hand dynamometer and 3 different approaches were adopted: (a) HGS in kilogram-force, (b) normalized HGS (HGS/body mass), and (c) allometric HGS (HGS/body mass-0.67). Binary logistic regression was used to verify the association between HGS indexes and HBP, and the receiver operating characteristic (ROC) was used to determine the possible use of HGS as a diagnostic tool for HBP. Handgrip strength indexes were not associated with HBP (p > 0.05), and ROC analyses showed a nonsignificant discriminating accuracy for most of the HGS indexes analyzed (p > 0.05) in identifying HBP in boys and girls. The area under curve (AUC) values ranged from 0.499 (95% CI [0.403-0.596] for allometric HGS among overweight or obese boys) to 0.595 (95% CI [0.546-0.643] for HGS among boys). Handgrip strength was not associated with HBP, and its use in the screening of HBP in adolescents is not recommended.

Turbulence Hierarchy and Multifractality in the Integer Quantum Hall Transition.

We offer a new perspective on the problem of characterizing mesoscopic fluctuations in the interplateau regions of the integer quantum Hall transition. We found that longitudinal and transverse conductance fluctuations, generated by varying the external magnetic field within a microscopic model, are multifractal and lead to distributions of conductance increments (magnetoconductance) with heavy tails (intermittency) and signatures of a hierarchical structure (cascade) in the corresponding stochastic process, akin to Kolmogorov's theory of fluid turbulence. We confirm this picture by interpreting the stochastic process of the conductance increments in the framework of H theory, which is a continuous-time stochastic approach that incorporates the basic features of Kolmogorov's theory. The multifractal analysis of the conductance "time series," combined with the H-theory formalism, provides strong support for the overall characterization of mesoscopic fluctuations in the quantum Hall transition as a multifractal stochastic phenomenon with multiscale hierarchy, intermittency, and cascade effects.

Muscular Fitness and Cardiovascular Risk Factors in Children and Adolescents: A Systematic Review.

Rodrigues de Lima, T, Custódio Martins, P, Henrique Guerra, P, and Augusto Santos Silva, D. Muscular fitness and cardiovascular risk factors in children and adolescents: A systematic review. J Strength Cond Res 34(8): 2394-2406, 2020-The purpose of this study was to identify and summarize the relationships between muscular fitness (MF) and individual components of metabolic syndrome (high waist circumference [WC], high blood pressure [BP], high systolic BP [SBP], high diastolic BP [DBP], high triglycerides [TG], fasting blood glucose [FG], and low HDL cholesterol levels [HDL-C]) in children and adolescents. A systematic review was conducted in 5 electronic databases, with complementary searches in reference lists, and the inclusion criteria were children and adolescents (age group up to 19 years of age) with no special clinical conditions. In all articles, risk of bias was analyzed by a standardized instrument. Of the 5,973 articles initially identified, 21 were included, with data on 22,261 children and adolescents. Higher MF values were associated with lower TG (n = 07) and WC values (n = 15). Different results in relation to the relationship between MF and SBP (n = 10) and MF and DBP (n = 07) were verified. In addition, there was no relationship between MF and FG (n = 06). In addition, inconclusive results were verified in the relationship between MF and HDL-C (n = 07). Concluded higher MF values were related to lower WC values and lower TG concentrations.

Effect of Macleaya cordata and Magnolia officinalis plant extracts on oxidative stress control in lambs fed a high-concentrate diet.

OBJECTIVE: The objective of this experiment was to compare conventional antioxidants and plant extracts for oxidative stress control in lambs fed a high-concentrate diet. METHODS: Forty-eight male Dorper×Santa Ines lambs with an initial weight of 20±1.49 kg and 60 days of age, were used to evaluate the effects of feeding a combination of Macleaya cordata and Magnolia officinalis plant extracts (0 vs 320 mg/kg dry matter [DM]) in combination with selenium+vitamin E (0 vs 100 IU/kg DM of vitamin E and 0.1 mg/kg DM of selenium) in a completely randomized block design in a 2×2 factorial arrangement. The animals were housed in individual pens and received a high-concentrate diet consisting of 80% whole corn and 20% protein pellet for 60 days. The animals were weighed at the beginning of the experiment and every 14 days for performance monitoring. Three blood samplings were performed during the experimental period for the evaluation of oxidative and protein parameters. RESULTS: The treatments with vitamin E and selenium as additives had a positive influence on final weight, daily weight gain, carcass weight, and selenium content in longissimus muscle (p = 0.01). Plant extracts tended to improve final weight (p = 0.064) and daily weight gain (p = 0.059), showing similar effect as selenium and vitamin E. There was no effect of treatment on blood proteins, indicating that the animals were healthy throughout the experiment. CONCLUSION: The use of plant extracts had a similar effect as the addition of selenium and vitamin E, with dietary inclusion of additives resulting in better performance of lambs but both supplements did not have strong influence on oxidative stress.

Resistance training reduces depressive symptoms in elderly people with Parkinson disease: A controlled randomized study.

BACKGROUND: Depression affects up to 40% of individuals with Parkinson's disease (PD). PURPOSE: To assess resistance training effects on the depressive symptoms of elderly PD patients. STUDY DESIGN: A randomized control study. METHODS: Thirty-three patients (aged ≥ 60 years) were randomly divided into two groups: (a) control group: n = 16 and (b) resistance training group (RTG): n = 17. All patients with Parkinson's disease (stage 1-3 on the Hoehn and Yahr scale). The RTG, in addition to maintaining their pharmacological treatments, performed 20 weeks of resistance training. The control group maintained their pharmacological treatments. Depressive symptoms, quality of life, unified Parkinson's Disease scale, and functional capacity were evaluated in both groups. RESULTS: The RTG presented a significant reduction (P < .05) of depressive symptoms (pre = 17.9 ± 8 score; post = 10.3 ± 6 score; effect size: -0.48), improved quality of life (pre = 40.3 ± 21.1 score; post = 30.2 ± 16.8 score; effect size: -0.26), and improved UPDRS (pre = 64 ± 34.6 score; post = 49.1 ± 24.1 score; effect size: -0.24). No significant changes in the control group regarding depressive symptoms (pre = 18.7 ± 5.4 score; post = 19.4 ± 5.2 score; effect size: 0.07), quality of life (pre = 39 ± 16.1 score; post = 40.6 ± 15.6 score; effect size: 0.05), and UPDRS (pre = 61.1 ± 24.3 score; post = 64.9 ± 23.4 score; effect size: 0.08) after 20 weeks. CONCLUSION: Resistance training reduces depressive symptoms and improves the quality of life and functionality of elderly with PD.

Effects of intracameral ascorbic acid on the corneal endothelium of dogs undergoing phacoemulsification.

OBJECTIVE: Cataracts are the most common ocular disorder in dogs. Phacoemulsification is the preferred treatment method among ophthalmologists, but the cellularity of the endothelium must be considered for its success, as endothelial lesions may produce permanent corneal decompensation. The objective of this study was to evaluate the effects of intracameral ascorbic acid, a known antioxidant, on the corneal endothelium of dogs undergoing phacoemulsification. ANIMAL STUDIED: In all, 40 eyes from 20 dogs, males and females from 7 to 12 years of age, were assessed for mature cataracts. PROCEDURES: Two groups were formed (n = 20): Group 1 (G1) received a balanced salt solution (BSS), whereas Group 2 (G2) received sterile ascorbic acid diluted in a BSS, at a final concentration of 0.001 m ascorbic acid. The corneal endothelium was assessed via non-contact specular microscopy at multiple time points before and after phacoemulsification. Cell density (cells/mm2 ) and area (mm2 ), corneal thickness (mm), hexagonality, and the coefficient of variation of cell size were all assessed. P values equal to or less than 0.05 were considered significant. RESULTS: With respect to the density of endothelial cells, both groups showed losses, but they were less severe in G2. There were no differences in corneal thickness. Hexagonality decreased significantly in the postoperative period in G1. Also in G1, the coefficient of variation of cell size increased significantly. CONCLUSION: According to the results obtained, ascorbic acid minimizes cellular losses in the corneal endothelium.

Ophthalmic parameters in adult lowland paca (Cuniculus paca) raised in captivity.

OBJECTIVE: To investigate the ophthalmic parameters of lowland pacas, including the anatomic features, tear production, intraocular pressure, central corneal thickness, and morphology of the corneal endothelium. ANIMALS STUDIED: Thirteen adult, anesthetized Cuniculus paca. PROCEDURE: Eyes were evaluated using slit-lamp biomicroscopy, the Schirmer tear test I, digital applanation tonometry, binocular indirect ophthalmoscopy, and noncontact specular microscopy. RESULTS: The biomicroscopy findings showed blue/brown pigmented bulbar conjunctivae, well-developed cilia (only in the upper eyelid margin), superior and inferior lacrimal puncta, brown irides, round pupils, and vestiges of the nictitating membrane. The results of the Schirmer tear test I revealed (mean ± SD) a lacrimation rate of 4.10 ± 0.44 mm/min. The intraocular pressure was 6.34 ± 0.43 mmHg. Central corneal thickness measured by specular microscopy was 0.35 ± 0.01 mm. The mean values of density, hexagonality, and the area of the endothelial cells were 2083.15 ± 42.47 cells/mm2 , 67.07 ± 3.30%, and 486.30 ± 9.56 µm2 , respectively. CONCLUSIONS: The ocular parameters defined in this study may be used for reference in future studies and might also contribute to therapeutic approaches appropriate to this species.

Correction to: Socioeconomic and demographic characterization of an endemic malaria region in Brazil by multiple correspondence analysis.

After publication of the article [1], it has been brought to our attention that the y-axis of Fig. 6 has been labeled incorrectly. It should read "linear predictor". This has now been corrected in the original article.

Socioeconomic and demographic characterization of an endemic malaria region in Brazil by multiple correspondence analysis.

BACKGROUND: In the process of geographical retraction of malaria, some important endemicity pockets remain. Here, we report results from a study developed to obtain detailed community data from an important malaria hotspot in Latin America (Alto Juruá, Acre, Brazil), to investigate the association of malaria with socioeconomic, demographic and living conditions. METHODS: A household survey was conducted in 40 localities (n = 520) of Mâncio Lima and Rodrigues Alves municipalities, Acre state. Information on previous malaria, schooling, age, gender, income, occupation, household structure, habits and behaviors related to malaria exposure was collected. Multiple correspondence analysis (MCA) was applied to characterize similarities between households and identify gradients. The association of these gradients with malaria was assessed using regression. RESULTS: The first three dimensions of MCA accounted for almost 50% of the variability between households. The first dimension defined an urban/rurality gradient, where urbanization was associated with the presence of roads, basic services as garbage collection, water treatment, power grid energy, and less contact with the forest. There is a significant association between this axis and the probability of malaria at the household level, OR = 1.92 (1.23-3.02). The second dimension described a gradient from rural settlements in agricultural areas to those in forested areas. Access via dirt road or river, access to electricity power-grid services and aquaculture were important variables. Malaria was at lower risk at the forested area, OR = 0.55 (1.23-1.12). The third axis detected intraurban differences and did not correlate with malaria. CONCLUSIONS: Living conditions in the study area are strongly geographically structured. Although malaria is found throughout all the landscapes, household traits can explain part of the variation found in the odds of having malaria. It is expected these results stimulate further discussions on modelling approaches targeting a more systemic and multi-level view of malaria dynamics.

The influence of customized abutments and custom metal abutments on the presence of the interproximal papilla at implants inserted in single-unit gaps: a 1-year prospective clinical study.

OBJECTIVES: To assess and compare the papilla presence mesially and distally to dental implants restored with customized abutments and custom metal abutments in the anterior maxilla. MATERIAL AND METHODS: Thirty-eight patients receiving 38 single-tooth implants, restored with 26 customized abutments and 12 custom metal abutments in the anterior maxillary region were enrolled in this study. The cases where did not existed contact point were excluded. Presence/absence of the interproximal papilla, inter-tooth-implant distance (ITD) and distance from the base of the contact point to dental crest bone of adjacent tooth (CPB) were accessed. Global P-values were determined for changes in CPB and papilla score over time (P < 0.05). RESULTS: Thirty-six patients with 36 implants were available for the 12-month follow-up. The abutments and reconstruction survival rate was 100% with no fracture or crown loss. A mean mesial CPB of 5.71 ± 1.54 mm and distal CPB of 4.01 ± 1.73 mm were assessed in the customized abutment group for an overall mean papilla presence of 1.69 ± 0.46. A mean mesial CPB of 5.41 ± 1.31 mm and distal CPB of 4.77 ± 1.21 mm were assessed in the control group for an overall mean papilla presence of 1.08 ± 0.65. CONCLUSIONS: The restoration of single-implants using computer-assisted design/computer-assisted manufacturing abutments appears to help maintaining a regular papillary filling although the variations of the implant positioning or the restoration/teeth relation.

A DTU-dependent blood parasitism and a DTU-independent tissue parasitism during mixed infection of Trypanosoma cruzi in immunosuppressed mice.

Trypanosoma cruzi (Tc) diversity is determined by different biological, genetic, and biochemical markers and has been grouped into six discrete typing units (DTUs) or taxonomic groups (TcI-TcVI). This variability, coupled with natural reinfection or the hosts' immunosuppression, may play an important role in the pathogenesis of Chagas disease. Therefore, we evaluated the blood and tissue parasitism and genetic profile of mice coinfected with the TcII (JG) strain and TcI AQ1-7 (AQ) or MUTUM (MT) strains during the acute and chronic phases of the disease and during immunosuppression. T. cruzi blood populations in mixed infections were clearly associated with the TcII strain during acute and chronic phases or during immunosuppression. However, in tissues, the parasite populations were distributed according to the strain and the stage of infection. TcII populations overlapped TcI strains during the acute phase; in contrast, during chronic phase, both TcI strains were more prevalent than the TcII strain. The immunosuppression induced selective exacerbation of parasite populations, leading to reactivation of the TcII strain when associated with the AQ, but not with MT strain. Thus, a differential distribution of T. cruzi populations in blood and tissues with overlapping according to the stage of infection and strain used was observed. Blood parasitism was associated with the DTU TcII and tissue parasitism with a specific parasite strain and not with DTUs. Finally, to our knowledge, this is the first study to analyze subpatent blood parasitism and to simultaneously identify different T. cruzi populations in tissues and blood.

Temperature-dependent development of two neotropical parasitoids of Liriomyza sativae (Diptera: Agromyzidae).

We studied two species of neotropical parasitoids that occur naturally in northeastern Brazil and are associated with Liriomyza sativae (Blanchard): Opius (Gastrosema) scabriventris Nixon (Hymenoptera: Braconidae) and Chrysocharis vonones (Walker) (Hymenoptera: Eulophidae). We evaluated the influence of seven temperatures on the duration of the egg-adult period and on the survivorship of the immature stages of the parasitoids. A temperature increase from 15 to 30°C shortened the egg-adult period of O. scabriventris and C. vonones. However, at 32°C, the developmental time for the braconid was prolonged, and no difference was observed for the eulophid, compared with 30°C. The highest temperature, 35°C, proved to be lethal for both species. At 15°C, C. vonones pupal survivorship was drastically reduced, whereas that of O. scabriventris was unaffected. At most temperatures, the eulophid had an egg-adult period shorter than or similar to the braconid, except at 15°C. The threshold temperature (Tt) of the egg-adult period for O. scabriventris was 7.3°C with a thermal constant (K) of 257.1 degree days (DD). For C. vonones the Tt was 7.4°C for the total cycle and 6.2°C for the pupal stage, with a thermal constant of 246.3 and 140.3 DD, respectively. These data allow an estimate of 29.4 annual generations for O. scabriventris and 30.5 for C. vonones in a melon production region in northeastern Brazil, values that are equivalent to 4.9 and 6.0 more generations than the host. These results demonstrate that both species have potential for application in biological control programs against the leafminer fly L. sativae.

Muscle Strength Indexes and Its Association With Cardiometabolic Risk Factors in Adolescents: An Allometric Approach.

Background and aims: Muscle strength (MS) has been associated with better cardiometabolic health prognosis. However, the result for the beneficial relationship seems to be dependent on the influence of body size in determining MS levels. We investigate the association between allometric MS indexes and its association with cardiometabolic risk factors in adolescents. Methods: It was a cross-sectional study comprising 351 adolescents (male: 44.4%; age range 14-19 years) from Southern Brazil. MS was assessed by handgrip strength and three different allometric approaches were adopted: 1) MS index based on theoretical allometric exponent; 2) MS index including body mass and height; 3) MS index including fat-free mass and height. Obesity, high blood pressure, dyslipidemia, glucose imbalance and high-sensitivity C-reactive protein were investigated as individual factors or as combinations (either as combinations of components - presence of two adverse conditions, or number of components present in an individual - 0, 1, 2, 3+ cardiometabolic risk factors). Logistic and multinomial logistic regression analyses adjusted for confounding factors were used. The statistical significance adopted was 5%. Results: MS index based on theoretical allometric exponent was associated with lower likelihood (OR: 0.54; 95% CI: 0.28 - 0.89) for the presence of three or more cardiometabolic risk factors in the same individual. Conclusion: This study suggests that MS index based on the theoretical allometric exponent can be superior to allometric MS indexes that included body mass and height, or fat-free mass and height in representing the presence of high number of cardiometabolic risk factors in adolescents.

Health-Related Physical Fitness Evaluation in HIV-Diagnosed Children and Adolescents: A Scoping Review.

BACKGROUND: Health-related physical fitness has been widely used to investigate the adverse effects of HIV infection/ART in children and adolescents. However, methods/protocols and cut-points applied for investigating health-related physical fitness are not clear. The aim of this scoping review was to map the literature to identify gaps in knowledge regarding the methods/protocols and cut-points. METHODS: A scoping review, following the Joana Briggs Institute (JBI) guidelines, was conducted through ten major databases. Search followed the PCC strategy to construct block of terms related to population (children and adolescents), concept (health-related physical fitness components) and context (HIV infection). RESULTS: The search resulted in 7545 studies. After duplicate removal, titles and abstracts reading and full text assessment, 246 studies were included in the scoping review. Body composition was the most investigated component (n = 244), followed by muscular strength/endurance (n = 23), cardiorespiratory fitness (n = 15) and flexibility (n = 4). The World Health Organization growth curves, and nationals' surveys were the most reference values applied to classify body composition (n = 149), followed by internal cut-points (n = 30) and cut-points developed through small populations (n = 16). Cardiorespiratory fitness was classified through cut-points from three different assessment batteries, as well as cut-points developed through studies with small populations, muscular strength/endurance and flexibility were classified through the same cut-points from five different assessment batteries. CONCLUSIONS: The research on muscular strength/endurance, cardiorespiratory fitness and flexibility has been scarcely explored. The lack of studies that investigated method usability as well as reference values was evidenced.

Predicting the Need for Blood Transfusions in Cardiac Surgery: A Comparison between Machine Learning Algorithms and Established Risk Scores in the Brazilian Population.

INTRODUCTION: Blood transfusion is a common practice in cardiac surgery, despite its well-known negative effects. To mitigate blood transfusion-associated risks, identifying patients who are at higher risk of needing this procedure is crucial. Widely used risk scores to predict the need for blood transfusions have yielded unsatisfactory results when validated for the Brazilian population. METHODS: In this retrospective study, machine learning (ML) algorithms were compared to predict the need for blood transfusions in a cohort of 495 cardiac surgery patients treated at a Brazilian reference service between 2019 and 2021. The performance of the models was evaluated using various metrics, including the area under the curve (AUC), and compared to the commonly used Transfusion Risk and Clinical Knowledge (TRACK) and Transfusion Risk Understanding Scoring Tool (TRUST) scoring systems. RESULTS: The study found that the model had the highest performance, achieving an AUC of 0.7350 (confidence interval [CI]: 0.7203 to 0.7497). Importantly, all ML algorithms performed significantly better than the commonly used TRACK and TRUST scoring systems. TRACK had an AUC of 0.6757 (CI: 0.6609 to 0.6906), while TRUST had an AUC of 0.6622 (CI: 0.6473 to 0.6906). CONCLUSION: The findings of this study suggest that ML algorithms may offer a more accurate prediction of the need for blood transfusions than the traditional scoring systems and could enhance the accuracy of predicting blood transfusion requirements in cardiac surgery patients. Further research could focus on optimizing and refining ML algorithms to improve their accuracy and make them more suitable for clinical use.

Drebrin controls neuronal migration through the formation and alignment of the leading process.

Formation of a functional nervous system requires neurons to migrate to the correct place within the developing brain. Tangentially migrating neurons are guided by a leading process which extends towards the target and is followed by the cell body. How environmental cues are coupled to specific cytoskeletal changes to produce and guide leading process growth is unknown. One such cytoskeletal modulator is drebrin, an actin-binding protein known to induce protrusions in many cell types and be important for regulating neuronal morphology. Using the migration of oculomotor neurons as a model, we have shown that drebrin is necessary for the generation and guidance of the leading process. In the absence of drebrin, leading processes are not formed and cells fail to migrate although axon growth and pathfinding appear grossly unaffected. Conversely, when levels of drebrin are elevated the leading processes turn away from their target and as a result the motor neuron cell bodies move along abnormal paths within the brain. The aberrant trajectories were highly reproducible suggesting that drebrin is required to interpret specific guidance cues. The axons and growth cones of these neurons display morphological changes, particularly increased branching and filopodial number but despite this they extend along normal developmental pathways. Collectively these results show that drebrin is initially necessary for the formation of a leading process and subsequently for this to respond to navigational signals and grow in the correct direction. Furthermore, we have shown that the actions of drebrin can be segregated within individual motor neurons to direct their migration independently of axon guidance.

An Overview of Cefiderocol's Therapeutic Potential and Underlying Resistance Mechanisms.

Antimicrobial resistance continues to increase globally and treatment of difficult-to-treat (DTT) infections, mostly associated with carbapenem-resistant (CR) Pseudomonas aeruginosa, CR Acinetobacter baumannii, and CR- and third-generation-cephalosporins-resistant Enterobacterales remains a challenge for the clinician. The recent approval of cefiderocol has broaden the armamentarium for the treatment of patients with DTT infections. Cefiderocol is a siderophore cephalosporin that has shown excellent antibacterial activity, in part due to its innovative way of cell permeation. It is relatively stable compared to most commonly found carbapenamases. However, some resistant mechanisms to cefiderocol have already been identified and reduced susceptibility has developed during patient treatment, highlighting that the clinical use of cefiderocol must be rational. In this review, we summarize the current available treatments against the former resistant bacteria, and we revise and discuss the mechanism of action of cefiderocol, underlying the biological function of siderophores, the therapeutic potential of cefiderocol, and the mechanisms of resistance reported so far.