Comparison of a daily and alternate-day photobiomodulation protocol in the prevention of oral mucositis in patients undergoing radiochemotherapy for oral cancer: a triple-blind, controlled clinical trial.

BACKGROUND: Preventive Photobiomodulation Therapy (PBMT) significantly reduces oral mucositis (OM) severity in patients undergoing Radiochemotherapy (RCT) for the treatment of oral cancer, but daily applications generate cost, overload the dental team, and reduce the number of patients assisted.To evaluate the effectiveness of two PBMT protocols in preventing OM in patients undergoing RCT for oral cancer. MATERIAL AND METHODS: 16 patients diagnosed with oral cancer undergoing RCT were included, equally divided into two groups: a group treated daily with PBMT, and another group also submitted to daily treatment, however, performing the application of PBMT every three days, interspersed with a simulation of PBMT (placebo). A red laser was used (~660 nm), 0.1W power, 1J of energy applied per point, 9 points per area (labial mucosa, buccal mucosa, lateral borders of the tongue, body of the tongue, and floor of the mouth) from the beginning of RCT until the end of the oncological treatment. Daily assessments were performed regarding OM scores, the World Health Organization (WHO) pain scale, and the visual analog scale (VAS). Weight, salivary flow (SGAPP), OHIP-14, and DMFT were evaluated on the initial and final days of RT. OM incidence and clinical data were compared by Pearson's chi-square test or Fisher's exact test. Pain and other scale scores were compared using the Mann-Whitney and Friedman/Dunn tests (SPSS v20.0 p<0.05). RESULTS: In the group with PBMT on alternate days, there was an increase in the frequency of grade 2 and grade 3 oral mucositis and an increased risk of grade 2 oral mucositis, in addition to higher mean pain scores and greater reduction in salivary flow. CONCLUSIONS: The daily PBMT protocol proved more effective in controlling the frequency and severity of OM, pain, and salivary flow.

Risk factors for oral mucositis during chemotherapy treatment for solid tumors: a retrospective STROBE-guided study.

BACKGROUND: This study retrospectively analyzed the risk factors for transchemotherapy oral mucositis (OM). MATERIAL AND METHODS: Before each chemotherapy cycle, patients were routinely evaluated for the presence/severity of OM based on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 scale for adverse effects and graded as follows: However, specific conditions such as mucositis are graded on a five-point scale: 0, absence of mucositis, grade 1 (Asymptomatic or mild), 2 (Presence of pain and moderate ulceration, without interference with food intake), 3 (severe pain with interference with food intake) or 4 (Life-threatening with the need for urgent intervention). Information from 2 years of evaluations was collected and patient medical records were reviewed to obtain data on chemotherapy cycle, sex, age, body mass index, body surface area, primary tumor, chemotherapy protocol, and history of head and neck radiotherapy. The X² test and multinomial logistic regression were used for statistical analysis (SPSS 20.0, p<0.05). RESULTS: Among 19,000 total evaluations of 3,529 patients during 5.32±4.7 chemotherapy cycles (CT) the prevalence of OM was 6.3% (n=1,195). Chemotherapy duration (p<0.001), female sex (p=0.001), adjuvant intention (p=0.008) and the use of carboplatin (p=0.001), cisplatin (p=0.029), docetaxel (p<0.001) and bevacizumab (p=0.026) independently increased the risk of mucositis. In head and neck tumors, 2018 year (p=0.017), chemotherapy duration (p=0.018), BMI>30 (p=0.008), radiotherapy (p=0.037) and use of carboplatin (p=0.046) and cyclophosphamide (p=0.010) increased this prevalence. CONCLUSIONS: Cycles of chemotherapy, sex, cytotoxicity drugs, bevacizumab and head and neck radiotherapy increase the risk of OM in solid tumors.

Immune aging in diabetes and its implications in wound healing.

Immune systems have evolved to recognize and eliminate pathogens and damaged cells. In humans, it is estimated to recognize 109 epitopes and natural selection ensures that clonally expanded cells replace unstimulated cells and overall immune cell numbers remain stationary. But, with age, it faces continuous repertoire restriction and concomitant accumulation of primed cells. Changes shaping the aging immune system have bitter consequences because, as inflammatory responses gain intensity and duration, tissue-damaging immunity and inflammatory disease arise. During inflammation, the glycolytic flux cannot cope with increasing ATP demands, limiting the immune response's extent. In diabetes, higher glucose availability stretches the glycolytic limit, dysregulating proteostasis and increasing T-cell expansion. Long-term hyperglycemia exerts an accumulating effect, leading to higher inflammatory cytokine levels and increased cytotoxic mediator secretion upon infection, a phenomenon known as diabetic chronic inflammation. Here we review the etiology of diabetic chronic inflammation and its consequences on wound healing.

Antibacterial properties and modulation analysis of antibiotic activity of NaCe(MoO4)2 microcrystals.

This study reports the antibacterial properties and modulation analysis of antibiotic activity by NaCe(MoO4)2 microcrystals as well as their structural and morphological characterization. Evaluation of the antibacterial and antibiotic-modulating activity was carried out using the broth microdilution method. The Minimum Inhibitory Concentrations (MICs) of the compounds were expressed as the geometric mean of the triplicate values obtained through the use of Resazurin. Compound concentrations in the plates ranged from 512 to 0.5 µg/mL. Regarding its direct antibacterial activity, NaCe(MoO4)2 had a MIC ≥ 1024 µg/mL against all studied strains. As for its modulatory effect, it presented synergism with the antibiotic Gentamicin against the S. aureus strain and with Norfloxacin against E. coli, causing a reduction of 75% and 60%, respectively, in the antibiotic quantity required to have the same effect on the strain in study.

A comprehensive survey of Aeromonas sp. and Vibrio sp. in seabirds from southeastern Brazil: outcomes for public health.

AIMS: To perform a microbiological survey regarding the presence, prevalence and characterization of Aeromonas sp. and Vibrio sp. in debilitated wrecked marine birds recovered from the centre-north coast of the state of Rio de Janeiro, Brazil. METHODS AND RESULTS: Swabs obtained from 116 alive and debilitated wrecked marine birds, comprising 19 species, from the study area were evaluated by biochemical methods. Antimicrobial susceptibility tests and pathogenicity gene screening were performed for bacterial strains of public health importance. Vibrio sp. and Aeromonas sp. were identified, as well as certain pathogenic genes and resistance to selected antimicrobials. CONCLUSIONS: This study demonstrates that the identified bacteria, mainly Vibrio sp., are fairly prevalent and widespread among several species of seabirds and highlights the importance of migratory birds in bacterial dispersion. In addition, it demonstrates the importance of the bacterial strains regarding their pathogenic potential. Therefore, seabirds can act as bacterial reservoirs, and their monitoring is of the utmost importance in a public health context. SIGNIFICANCE AND IMPACT OF THE STUDY: The study comprehensively evaluates the importance of seabirds as bacteria of public health importance reservoirs, since birds comprising several pathogenic bacterial species were evaluated.

Mechanical Resonators for Quantum Optomechanics Experiments at Room Temperature.

All quantum optomechanics experiments to date operate at cryogenic temperatures, imposing severe technical challenges and fundamental constraints. Here, we present a novel design of on-chip mechanical resonators which exhibit fundamental modes with frequencies f and mechanical quality factors Q_{m} sufficient to enter the optomechanical quantum regime at room temperature. We overcome previous limitations by designing ultrathin, high-stress silicon nitride (Si_{3}N_{4}) membranes, with tensile stress in the resonators' clamps close to the ultimate yield strength of the material. By patterning a photonic crystal on the SiN membranes, we observe reflectivities greater than 99%. These on-chip resonators have remarkably low mechanical dissipation, with Q_{m}∼10^{8}, while at the same time exhibiting large reflectivities. This makes them a unique platform for experiments towards the observation of massive quantum behavior at room temperature.

Cost comparison of pressure ulcer preventive dressings: hydrocolloid dressing versus transparent polyurethane film.

OBJECTIVE: To evaluate and compare the costs of using a transparent polyurethane film (PF) and hydrocolloid dressing (HD) in the prevention of pressure ulcers (PUs). METHOD: This descriptive, observational, longitudinal, comparative study was conducted in the intensive care units, coronary care unit and medical clinic of a charity hospital in Brazil. Data were collected during a 30-day study period, consisting of physical examination, assessment of risk factors for PU development and application of the Braden scale, which were performed at inclusion in the study and once daily during hospitalisation. Either PF or HD was applied bilaterally in the sacral and trochanteric regions for prevention of PUs in patients at a moderate to high risk of PUs according to the Braden scale, and costs of using PU preventive dressings were estimated. RESULTS: The mean total costs per dressing change per patient when using the HD and PF to prevent PUs were 413.60 BRL and 74.04 BRL, respectively. There were significant between-group differences in mean costs for all variables, except for saline solution and nurse-technician services. CONCLUSION: Results showed that the mean cost per dressing change per patient was lower when using the transparent PF than when using the HD.

Behavioural changes and muscle strength in Rattus norvegicus experimentally infected with Toxocara cati and T. canis.

Toxocara canis and Toxocara cati are nematode parasites in dogs and cats, respectively, transmitted by ingestion of embryonated eggs, transmammary and transplacental (T. canis) routes and paratenic host predation. Many parasites use mechanisms that change the behaviour of their hosts to ensure continued transmission. Several researchers have demonstrated behavioural changes in mouse models as paratenic hosts for T. canis. However, there have been no studies on behavioural changes in laboratory rats (Rattus norvegicus) experimentally infected with T. cati. This study investigated behavioural changes and muscle strength in male and female rats experimentally infected with T. cati or T. canis in acute and chronic phases of infection. Regardless of sex, rats infected with T. cati showed a greater decrease in muscle strength 42 days post infection compared to rats infected with T. canis. However, behavioural changes were only observed in female rats infected with T. canis.

Evaporation of volatile compounds in suspended-core fibers.

A sensing configuration for fluid evaporation monitoring using a suspended-core fiber tip is proposed. Strong differences between the evaporation processes of acetone and isopropyl alcohol were observed, both in terms of the signal's intensity fluctuations and total duration. In each fluid, the main signal variations were due to changes in reflectivity inside a collapsed region of the suspended-core fiber near the spliced interface with a standard single-mode fiber. After further analysis with a wider array of substances, this configuration could, in the future, be used to detect and study the evaporation of different volatile organic compounds.

Physiological, morphological, and immunochemical parameters used for the characterization of clinical and environmental isolates of Acanthamoeba.

The factors that characterize Acanthamoeba strains as harmless or potentially pathogenic have not been elucidated. Analysing the in vitro and in vivo parameters of Acanthamoeba samples, including heat tolerance at temperatures close to that of the human body, cytopathic effects, and their ability to cause infections in animals, has been proposed to identify their pathogenic potential. Another promising criterion for differentiating strains is the analysis of their biochemical and immunochemical properties. In this study, a comparative evaluation between clinical and environmental Acanthamoeba isolates was performed on the basis of physiological, morphological, and immunochemical criteria. Crude antigens were used to characterize the protein profiles by electrophoresis and immunize mice to produce polyclonal and monoclonal antibodies. The antibodies were characterized using ELISA, Western blotting, and immunofluorescence techniques. The results obtained with polyclonal antibodies suggest the presence of specific proteins for each studied isolate and co-reactive immunochemical profiles among conserved components. Ten monoclonal antibody clones were obtained; mAb3 recognized 3 out of 4 samples studied. The results of this study may help standardize criteria for identifying and characterizing Acanthamoeba strains. Taken together, our results support the view that a set of features may help differentiate Acanthamoeba species and isolates.

Prevalence and predictors of nonadherence to hemodialysis.

BACKGROUND: The prevalence of nonadherence to dialysis (NAD) presents a wide variation, depending on the parameters used and demographic regions studied. This study aimed to assess the prevalence and predictors of NAD of patients with chronic kidney disease undergoing hemodialysis (HD). MATERIALS AND METHODS: This was a cross-sectional study with 255 adult patients receiving HD for >3 months. Skipping a session per month, shortening a session for at least 10 min, phosphorus >7.5 mg/dl, potassium >6.0 mmol/l and interdialytic weight gain (IDWG) >5.7% of body weight were indicative of NAD. The association of sociodemographic and clinical variables with NAD was assessed using logistic regression. RESULTS: Mean age was 50 ± 13.1 years, 62.7% were male, 85.5% were of African descent and 62% were married. The prevalence rates of NAD were: 49% of shortening sessions, 18% of hyperkalemia, 12% of hyperphosphatemia, 9% of IDWG >5.7% of dry weight and 8% of skipping HD. Independent predictors of NAD were: age ≤50 years, not being married, living alone, living in Salvador, attending dialysis without a companion, ethnic African descent, Kt/V <1.3 and residual diuresis <100 ml/day. CONCLUSION: NAD is frequent and distinct sociodemographic and clinical variables predict different parameters.

Ag2Mo3O10·2H2O nanorods under high pressure: In situ Raman spectroscopy.

This work presents a pressure-dependent behavior of silver trimolybdate dihydrate (Ag2Mo3O10·2H2O) nanorods using in situ Raman scattering. The Ag2Mo3O10·2H2O nanorods were obtained by the hydrothermal method at 140 °C for 6 h. The structural and morphological characterization of the sample was performed by powder X-ray diffraction (XRD) and scanning electron microscopy (SEM). Pressure-dependent Raman scattering studies were performed on Ag2Mo3O10·2H2O nanorods up to 5.0 GPa using a membrane diamond-anvil cell (MDAC). The vibrational spectra under high pressure showed splitting and emergence of new bands above 0.5 GPa and 2.9 GPa. Reversible phase transformations under pressure were observed in silver trimolybdate dihydrate nanorods: Phase I - ambient phase (1 atm - 0.5 GPa) â†’ Phase II (0.8 GPa - 2.9 GPa) â†’ Phase III (above 3.4 GPa).

In situ high-temperature Raman scattering study of monoclinic Ag2Mo2O7 microrods.

In this work, we present a temperature-dependent behavior of monoclinic silver dimolybdate (m-Ag2Mo2O7) microrods using in situ Raman scattering. The m-Ag2Mo2O7 microrods were obtained by the conventional hydrothermal method at 423 K for 24 h. The structural and morphological characterization of the sample has been done by powder X-ray diffraction (XRD) and scanning electron microscopy (SEM), respectively. Temperature-dependent Raman scattering measurements were performed on m-Ag2Mo2O7 microrods, and the results show an irreversible first-order structural phase transition at 698 K-723 K and the melting process at 773 K. Changes in the Raman spectra confirm the phase transition from the P21/c monoclinic structure to the P-1 triclinic structure. No morphological changes were observed during the structural phase transition of the sample at 723 K. Time-dependent optical microscopy at 773 K showed the growth of nanowires on the Ag2Mo2O7 microrods in the triclinic structure.

Crystal structure of the zinc-, cobalt-, and iron-containing adenylate kinase from Desulfovibrio gigas: a novel metal-containing adenylate kinase from Gram-negative bacteria.

Adenylate kinases (AK) from Gram-negative bacteria are generally devoid of metal ions in their LID domain. However, three metal ions, zinc, cobalt, and iron, have been found in AK from Gram-negative bacteria. Crystal structures of substrate-free AK from Desulfovibrio gigas with three different metal ions (Zn(2+), Zn-AK; Co(2+), Co-AK; and Fe(2+), Fe-AK) bound in its LID domain have been determined by X-ray crystallography to resolutions 1.8, 2.0, and 3.0 Å, respectively. The zinc and iron forms of the enzyme were crystallized in space group I222, whereas the cobalt-form crystals were C2. The presence of the metals was confirmed by calculation of anomalous difference maps and by X-ray fluorescence scans. The work presented here is the first report of a structure of a metal-containing AK from a Gram-negative bacterium. The native enzyme was crystallized, and only zinc was detected in the LID domain. Co-AK and Fe-AK were obtained by overexpressing the protein in Escherichia coli. Zn-AK and Fe-AK crystallized as monomers in the asymmetric unit, whereas Co-AK crystallized as a dimer. Nevertheless, all three crystal structures are very similar to each other, with the same LID domain topology, the only change being the presence of the different metal atoms. In the absence of any substrate, the LID domain of all holoforms of AK was present in a fully open conformational state. Normal mode analysis was performed to predict fluctuations of the LID domain along the catalytic pathway.

Analysis of the activation mechanism of Pseudomonas stutzeri cytochrome c peroxidase through an electron transfer chain.

The activation mechanism of Pseudomonas stutzeri cytochrome c peroxidase (CCP) was probed through the mediated electrochemical catalysis by its physiological electron donor, P. stutzeri cytochrome c-551. A comparative study was carried out, by performing assays with the enzyme in the resting oxidized state as well as in the mixed-valence activated form, using cyclic voltammetry and a pyrolytic graphite membrane electrode. In the presence of both the enzyme and hydrogen peroxide, the peak-like signal of cytochrome c-551 is converted into a sigmoidal wave form characteristic of an E(r)C'(i) catalytic mechanism. An intermolecular electron transfer rate constant of (4 ± 1) × 10(5) M(-1) s(-1) was estimated for both forms of the enzyme, as well as a similar Michaelis-Menten constant. These results show that neither the intermolecular electron transfer nor the catalytic activity is kinetically controlled by the activation mechanism of CCP in the case of the P. stutzeri enzyme. Direct enzyme catalysis using protein film voltammetry was unsuccessful for the analysis of the activation mechanism, since P. stutzeri CCP undergoes an undesirable interaction with the pyrolytic graphite surface. This interaction, previously reported for the Paracoccus pantotrophus CCP, induces the formation of a non-native conformation state of the electron-transferring haem, which has a redox potential 200 mV lower than that of the native state and maintains peroxidatic activity.

Molecular sexing of unusually large numbers of Spheniscus magellanicus (Spheniscidae) washed ashore along the Brazilian coast in 2008.

There have been few studies on Magellanic penguins (Spheniscus magellanicus). In 2008, these penguins washed ashore along the Brazilian coast in unusually high numbers, some reaching as far as northeast Brazil. As Magellanic penguins show little sexual dimorphism, sex determination by morphological features is not accurate. Here, we tested a molecular procedure for sexing specimens of S. magellanicus washed ashore along the coasts of Sergipe, Rio de Janeiro and Rio Grande do Sul in 2008, comparing the sex ratio between these localities. Tissue samples were collected from 135 dead, beached specimens. We carried out total genomic DNA extraction and CHD-Z/CHD-W gene amplification by PCR using P2 and P8 primers. Amplicons were separated by 12% acrylamide gel electrophoresis. We found a greater proportion of females (70%). Sex could be determined because females have two intronic regions of CHD gene of different size in the sex chromosomes, visualized as two bands on the gel (380 and 400 bp approximately), while males have only one (400 bp). Therefore, this method proved to be effective and sensitive for sex determination of S. magellanicus individuals. Data on sex ratios are useful for understanding the dynamics and ecology of Magellanic penguin populations.

Temperature-dependent phonon dynamics of Ag3PO4 microcrystals.

In this work, we present the study of the temperature-dependent behavior of silver orthophosphate (Ag3PO4) microcrystals using in situ Raman scattering. The Ag3PO4 as-synthesized microcrystals were prepared by the precipitation method and characterized by powder X-ray diffraction (XRD), scanning electron microscopy (SEM), Raman and infrared spectroscopy, and differential scanning calorimetry (DSC). Temperature-dependent phonon dynamics were performed on Ag3PO4 microcrystals and pointed to a first-order phase transition in the temperature range 500-515 °C: Phase I (25-500 °C) â†’ Phase II (515-590 °C). The phase transition is reversible and a temperature hysteresis was observed during the heating - cooling process: Phase II (590-470 °C) â†’ Phase I (455-25 °C). The reversible phase transition is related to the distortion of the tetrahedral symmetry of PO4 caused by the decrease in the crystalline order. DSC analysis confirmed the results of temperature-dependent Raman spectroscopy.

An analysis of the 1978 African swine fever outbreak in Brazil and its eradication.

The aim of this paper is to evaluate the African swine fever (ASF) outbreak that began in 1978 in Paracambi municipality, Rio de Janeiro State, Brazil, and the steps taken by the Brazilian authorities to eradicate the disease. The presence of ASF in the country was confirmed by isolating the virus, and its pathogenicity was certified by the laboratory of the Plum Island Disease Center, New York, United States. Even before the laboratory results became available, the Brazilian Agriculture Ministry declared an Animal Health Emergency, in which the official Veterinary Services adopted rapid control measures to restrain and eradicate the disease. These control measures contributed to the reorganisation of the national swine industry and stimulated the use of high-technology production techniques, as well as an improvement in herd health consciousness. All this contributed to Brazil becoming the largest meat exporter in the world.

Flood risk attenuation in critical zones of continental Portugal using sustainable detention basins.

According to the Floods Directive (Directive 60/2007/EC), the management of floods represents an obligation of each EU member state to defend human lives as well as the economic well-being of societies, especially in areas defined as critical. The purpose of this study was to develop a flood attenuation model based on detention basins in the 23 critical flood risk zones of continental Portugal, capable to eliminate the high and very high flood risk areas instead of attempting to ensure full control of the flood in all potentially threatened areas. The model workflow comprised the sequential use of engineering formulae based on historical peak flows and a zoning algorithm embedded in a Geographic Information System. The formulas allowed to set up the volume of river water to retain in a detention basin during a flood, as well as the smallest catchment area (A) producing this volume. The results were divided into sustainable (h ≤ 8 m) or non-sustainable (h > 8 m) detention basins. Thus, these results indicated the possibility to install 27 sustainable and 75 non-sustainable detention basins in specific catchments within the critical zones contributing watersheds. The number of sustainable detention basins is reduced by about 30% when the full flood control model is used. Because the construction of non-sustainable (engineered) dams is extremely costly, the only possible way to mitigate flood risk in these critical zones would be to couple flood attenuation with hydroelectric use, or through the implementation of an extensive reforestation program in the catchment with the purpose to increase evapotranspiration and reduce runoff.

Difficulty in detecting low levels of polymyxin resistance in clinical Klebsiella pneumoniae isolates: evaluation of Rapid Polymyxin NP test, Colispot Test and SuperPolymyxin medium.

Polymyxins are important therapeutic options for treating infections, mainly those caused by carbapenem-resistant Klebsiella pneumoniae. Specific chemical characteristics of polymyxins make it difficult to perform antimicrobial susceptibility testing, especially within the clinical laboratory. Here we aimed to evaluate the performance of three phenotypic methods: Rapid NP Polymyxin Test, ColiSpot test and the SuperPolymyxin medium. To accomplish this, 170 non-duplicate clinical K. pneumoniae isolates were analysed (123 colistin-resistant and 47 susceptible). The sensitivity and specificity obtained for Rapid Polymyxin NP Test, Colispot and SuperPolymyxin medium were, respectively, 90% and 94%, 74% and 100%, and 82% and 85%. Very major errors occurred more frequently in low-level colistin-resistant isolates (MICs 4 and 8 µg/mL). Rapid Polymyxin NP proved to be a method capable of identifying colistin-resistant strains in acceptable categorical agreement. However, major errors and very major errors of this method were considered unacceptable for colistin-resistance screening. Although the Colispot test is promising and easy to perform and interpret, the results did not reproduce well in the isolates tested. The colistin-containing selective medium (SuperPolymyxin) showed limitations, including quantification of mucoid colonies and poor stability. Nevertheless, Colispot and SuperPolymyxin medium methods did not present acceptable sensitivity, specificity and categorical agreement. It is essential to use analytical tools that faithfully reproduce bacterial resistance in vitro, especially in last-line drugs, such as polymyxins, when misinterpretation of a test can result in therapeutic ineffectiveness.