Effort-reward and overcommitment at work and psychiatric symptoms in healthcare professionals: The mediation role of allostatic load.

Background: Despite decades of advancement to support interventions for managing work-related stress, mental health issues have significantly escalated among healthcare professionals. Effort-reward imbalance (ERI) and overcommitment in the workplace are linked to several psychiatric disorders. However, the underlying biological mechanisms remain unclear. This study investigated whether ERI and overcommitment among healthcare professionals were linked to Allostatic Load (AL) and whether AL mediates the relationship between ERI, overcommitment and mental health issues. Methods: One hundred forty-two nursing workers (n = 142; 90.1 % female, mean age: 39.5 ± 9.6) were randomly recruited from a university hospital in Sao Paulo, Brazil, and applied the ERI scale that assesses work effort, reward, and overcommitment. The Perceived Stress Scale (PSS), The Beck Depression Inventory (BDI), and the Self-Report Questionnaire for psychiatric symptoms (SRQ-20) evaluated the mental health outcomes. Ten neuroendocrine, metabolic, immunologic and cardiovascular biomarkers were analyzed, and values were transformed into an AL index using clinical reference cutoffs. Results: Linear regression adjusted for covariates showed that higher scores for overcommitment were associated with higher AL indexes, which in turn were associated with higher SRQ-20, but not with PSS and DBI scores. As expected, higher scores for effort, lower for reward, and higher ERI were associated with higher scores for PSS, SRQ-20, and DBI, but not with AL index. Direct effect estimates showed that overcommitment was directly associated with higher SRQ-20 scores, and indirectly via AL. Conclusion: Our study reveals that overcommitment, rather than ERI, was linked to increased AL in healthcare workers. Additionally, AL mediates the relationship between overcommitment and higher psychiatric symptoms, highlighting a key mechanism by which work stress can lead to mental health problems. Individual's responses to high work demands need to be considered when designing predictive models and interventions for mental health issues.

Symptoms of anxiety and depression in patients with persistent asthma: a cross-sectional analysis of the INSPIRERS studies.

OBJECTIVES: Anxiety and depression are relevant comorbidities in asthma, but, in Portugal and Spain, data on this topic are scarce. We assessed, in patients with asthma, the frequency of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) and the European Quality of Life Five Dimension Questionnaire (EQ-5D); the level of agreement between these questionnaires, and the factors associated with these symptoms. METHODS: This is a secondary analysis of the INSPIRERS studies. A total of 614 adolescents and adults with persistent asthma (32.6±16.9 years, 64.7% female) were recruited from 30 primary care centres and 32 allergy, pulmonology and paediatric clinics. Demographic and clinical characteristics, HADS and EQ-5D were collected. A score ≥8 on Hospital Anxiety and Depression Scale-Anxiety/Hospital Anxiety and Depression Scale-Depression or a positive answer to EQ-5D item 5 indicated the presence of these symptoms. Agreement was determined by Cohen's kappa. Two multivariable logistic regressions were built. RESULTS: According to HADS, 36% of the participants had symptoms of anxiety and 12% of depression. According to EQ-5D, 36% of the participants had anxiety/depression. The agreement between questionnaires in identifying anxiety/depression was moderate (k=0.55, 95% CI 0.48 to 0.62). Late asthma diagnosis, comorbidities and female gender were predictors of anxiety/depression, while better asthma control, health-related quality of life and perception of health were associated with lower odds for anxiety/depression. CONCLUSION: At least 1/3 of the patients with persistent asthma experience symptoms of anxiety/depression, showing the relevance of screening these disorders in patients with asthma. EQ-5D and HADS questionnaires showed a moderate agreement in the identification of anxiety/depression symptoms. The identified associated factors need to be further investigated in long-term studies.

Physiological changes in green and red cherry tomatoes after photocatalytic ethylene degradation using continuous air flux.

In this work photocatalytic ethylene degradation (TiO2-UV) was applied in green cherry tomatoes with the aim to control biochemical and physiological changes during ripening. Photocatalytic process was performed at 18 °C ± 2 °C and 85% HR for 10 days using continuous air flux. Ethylene, O2 and CO2 concentration from cherry tomatoes under TiO2-UV and control (c) fruits, were measured by GC-MS for 10 days. After that, the tomatoes were stored for 20 days. During the photocatalysis process, ethylene was completely degraded and control fruits, the ethylene was 28.73 nL/g. Respiration rate was lower for fruits under TiO2-UV than control. During storage period, cherry tomatoes treated by TiO2-UV, showed lower ethylene concentration, respiration rate, total soluble solid, lycopene, sugar and organic acid content than control showing that the fruits treated with photocatalysis did not reach the full maturity. In addition, all the cherry tomatoes showed different maturity stages. Fungal incidence was higher in control fruits than fruits treated with photocatalysis. This research showed for the first time that photocatalytic technology preserved the physiological quality of cherry tomatoes for 30 days of storage, being a promised technology to preserve cherries tomatoes.

The Challenging Management of Acute Thrombotic Microangiopathy in Pregnancy.

Thrombotic microangiopathy is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ injury. Pregnancy-associated thrombotic microangiopathy is a severe disorder with a high risk of maternal mortality and poor fetal outcomes. Preeclampsia/eclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome are the most common causes, and hemolytic uremic syndrome or thrombotic thrombocytopenic purpura are rare causes. Due to overlapping clinical findings, the differential diagnosis is challenging and should be managed by a multidisciplinary team. We present a case of a 38-year-old woman at 40 weeks of second gestation, admitted with thrombotic microangiopathy being the final diagnosis not immediately clear.

Estimativa da prevalência oculta da hanseníase em um município do sul de Minas Gerais: onde estão os pacientes com hanseníase? / Estimation of the hidden prevalence of leprosy in a city in southern Minas Gerais: where are the leprosy patients? / Estimación de la prevalencia oculta de la lepra en una ciudad del sur de Minas Gerais: ¿dónde están los enfermos de lepra?

A hanseníase é uma doença crônica e infecto-contagiosa que possui diversas manifestações clínicas dermatológicas e neurológicas. Trata-se de um problema de saúde pública no Brasil devido aos elevados índices de novos casos. Assim, o Brasil é o segundo país com maior número de casos da doença no mundo e, portanto, necessita de uma vigilância epidemiológica efetiva. Dessa forma, o objetivo deste estudo é estimar a taxa de prevalência oculta da hanseníase em Alfenas-MG de 2006 a 2020. Realizou-se, primeiramente, um estudo quantitativo e descritivo dos casos de hanseníase diagnosticados no município de Alfenas-MG a partir de 2001, provenientes da análise de dados secundários obtidos no Sistema de Informação de Agravos de Notificação. Para o cálculo da taxa de prevalência oculta, foi utilizado o método proposto por Suárez e Lombardi e indicado pelas Organizações Pan-Americana e Mundial de Saúde/ Organização Mundial de Saúde. Comparando o resultado das décadas têm-se: queda de 82,16% de diagnósticos entre a primeira (n=314) e a segunda década (n=56); alta prevalência de pacientes multibacilares em ambas; incapacidade grau I e II em 55,10% dos pacientes na primeira década e, na segunda, 23,21% apresentaram incapacidade grau I e 0% incapacidade grau II; aumento de 1.093,70% da taxa de prevalência oculta da segunda década em relação ao período de 2006 à 2010. Destacamos que este estudo é essencial para que medidas de prevenção, controle e eliminação sejam elaboradas pelos órgãos competentes a fim de erradicar ou minimizar a hanseníase no sul de Minas Gerais. PALAVRAS-CHAVE: Hanseníase; Prevalência; Notificação; Saúde Pública.

Leprosy is a chronic and infectious-contagious disease that has several dermatological and neurological clinical manifestations. It is a public health problem in Brazil due to the high rates of new cases. Thus, Brazil is the second country with the highest number of cases of the disease in the world and, therefore, requires effective epidemiological surveillance. Thus, the aim of this study is to estimate the hidden prevalence rate of leprosy in Alfenas-MG from 2006 to 2020, from the analysis of secondary data obtained from the Notifiable Diseases Information System. To calculate the hidden prevalence rate, the method proposed by Suárez and Lombardi and recommended by the Pan American and World Health Organizations/World Health Organization was used. Comparing the results of the decades, there is: a drop of 82.16% in diagnoses between the first (n=314) and the second decade (n=56); high prevalence of multibacillary patients in both; grade I and II disability in 55.10% of patients in the first decade and, in the second, 23.21% had grade I disability and 0% grade II disability; 1,093.70% increase in the prevalence rate in the second decade compared to the period from 2006 to 2010. We emphasize that this study is essential for prevention, control and elimination measures to be developed by the competent bodies in order to eradicate or minimize leprosy in the south of Minas Gerais.

La lepra es una enfermedad crónica e infecto-contagiosa que presenta diversas manifestaciones clínicas dermatológicas y neurológicas. Constituye un problema de salud pública en Brasil debido a las altas tasas de nuevos casos. Así, Brasil es el segundo país con mayor número de casos de la enfermedad en el mundo y, por lo tanto, requiere una vigilancia epidemiológica eficaz. Así, el objetivo de este estudio es estimar la tasa de prevalencia oculta de lepra en Alfenas-MG de 2006 a 2020, a partir del análisis de datos secundarios obtenidos del Sistema de Información de Enfermedades de Declaración Obligatoria. Para el cálculo de la tasa de prevalencia oculta se utilizó el método propuesto por Suárez y Lombardi y recomendado por las Organizaciones Panamericana y Mundial de la Salud/Organización Mundial de la Salud. Comparando los resultados de las décadas, se observa: una caída de 82,16% en los diagnósticos entre la primera (n=314) y la segunda década (n=56); alta prevalencia de pacientes multibacilares en ambas; discapacidad grado I y II en 55,10% de los pacientes en la primera década y, en la segunda, 23,21% tenían discapacidad grado I y 0% discapacidad grado II; aumento de 1.093,70% en la tasa de prevalencia en la segunda década en comparación con el período de 2006 a 2010. Destacamos que este estudio es esencial para las medidas de prevención, control y eliminación a ser desarrolladas por los órganos competentes con el fin de erradicar o minimizar la lepra en el sur de Minas Gerais.

Cerebral arteriovenous malformation and foreign accent syndrome: a case report.

OBJECTIVE: This case study aims to present the Foreign Accent Syndrome (FAS) in a patient with Cerebral Arteriovenous Malformation (cAVM), considering neuropsychological, radiological and microsurgical aspects. METHODS: The patient underwent preoperative neuropsychological assessment and MRI and Tractography were performed to identify fibers close to the lesion site. In the surgical procedure, a craniotomy was performed for excision of the cAVM. After surgery and 6 months after the surgical procedure, the patient underwent further and neuropsychological evaluations. RESULTS: The presence of AVM located in the posterior part of the medial surface of the left superior frontal gyrus was identified and the neuropsychological evaluation found cognitive deficits and symptoms characteristic of FAS, which disappeared after resection. CONCLUSION: This report presented a case of cAVM in which symptoms were found even without rupture, which was no longer observed after the surgical procedure, demonstrating the relationship of cAVM with the symptoms and neuroanatomical bases of FAS.

Awake Microsurgical Resection for a Precentral Gyrus Arteriovenous Malformation-Three-Dimensional Video and Anatomic Landmarks.

Arteriovenous malformations (AVMs) are complex, heterogeneous, and uncommon neurovascular disorders that frequently manifest in young adults. Parenchymal AVMs are thought to be congenital, but this has been recently questioned in the literature.1,2 AVMs can change over time and cause focal neurological signs or neurocognitive deficits.3 The clinical presentation of an AVM is variable and depends mainly on the occurrence of bleeding as well as its location, size, and ability to take flow from adjacent areas.4 AVMs can be treated by a single modality or a combination of different modalities. According to the Expert Consensus on the Management of Brain Arteriovenous Malformations, neurosurgery may be the best option for Spetzler-Martin grade 2 AVMs.5 However, the treatment of these lesions when located in eloquent areas, especially in the central lobe, is controversial. Awake craniotomy allows identification of eloquent gyrus and can potentially facilitate resection with functional preservation. An alternative is stereotactic radiosurgery, but a qualitative comparative analysis revealed higher obliteration rate with awake AVM excision compared with stereotactic radiosurgery.6 Awake craniotomy was the earliest surgical procedure known, and it has become fashionable again. It was used in the past for surgical management of intractable epilepsy, but its indications are increasing, and it is a widely recognized technique for resection of mass lesions involving the eloquent cortex and for deep brain stimulation.7 Its application for resection of vascular lesions, including AVMs, is still limited. In the Video, we present a case of a cerebral AVM of the precentral gyrus in which we achieved complete resection with awake microsurgical treatment without any neurological sequelae for the patient.

Awake Microsurgical Resection for Optochiasmatic Cavernous Malformation.

Cavernous malformations (CM) affect approximately 0.5% of the population, with only a limited portion being located in the optic nerve and chiasma. The clinical presentation is determined by their locations. In the optochiasmatic CM, the acute visual disturbance is the most common presentation. Chronically, many show a progressive visual loss, chronic headache, and pituitary disturbances. The differential diagnosis includes optic glioma, arteriovenous malformations, aneurysm, craniopharyngioma, pituitary apoplexy, and inflammatory conditions. In Video 1, we present the case of a 39-year-old woman with a history of a hemorrhagic optochiasmatic cavernoma in 2016, who started using propranolol to reduce the lesion and symptoms of visual loss. Moreover, the first microsurgical resection of the cavernoma and evacuation of the hematoma were performed in the same year. Owing to evolvement from a partial to a total vision loss in the left eye and presentation of new symptoms in the right eye, the patient underwent microsurgical resection. The surgery was performed sequentially. An awake craniotomy was performed to monitor the chiasma and right optic nerve. The postoperative magnetic resonance imaging showed complete resection of the CM, and the patient fully recovered. The patient signed the institutional consent form, stating that he or she accepts the procedure and allows the use of his or her images and videos for any type of medical publications in conferences and/or scientific articles.

Experimental and theoretical studies of the gas-phase reactions of O(1D) with H2O and D2O at low temperature.

Here we report the results of an experimental and theoretical study of the gas-phase reactions between O(1D) and H2O and O(1D) and D2O at room temperature and below. On the experimental side, the kinetics of these reactions have been investigated over the 50-127 K range using a continuous flow Laval nozzle apparatus, coupled with pulsed laser photolysis and pulsed laser induced fluorescence for the production and detection of O(1D) atoms respectively. Experiments were also performed at 296 K in the absence of a Laval nozzle. On the theoretical side, the existing full-dimensional ground X 1A potential energy surface for the H2O2 system involved in this process has been reinvestigated and enhanced to provide a better description of the barrierless H-atom abstraction pathway. Based on this enhanced potential energy surface, quasiclassical trajectory calculations and ring polymer molecular dynamics simulations have been performed to obtain low temperature rate constants. The measured and calculated rate constants display similar behaviour above 100 K, showing little or no variation as a function of temperature. Below 100 K, the experimental rate constants increase dramatically, in contrast to the essentially temperature independent theoretical values. The possible origins of the divergence between experiment and theory at low temperatures are discussed.

Network analyses reveal the role of large snakes in connecting feeding guilds in a species-rich Amazonian snake community.

In ecological communities, interactions between consumers and resources lead to the emergence of ecological networks and a fundamental problem to solve is to understand which factors shape network structure. Empirical and theoretical studies on ecological networks suggest predator body size is a key factor structuring patterns of interaction. Because larger predators consume a wider resource range, including the prey consumed by smaller predators, we hypothesized that variation in body size favors the rise of nestedness. In contrast, if resource consumption requires specific adaptations, predators are expected to consume distinct sets of resources, thus favoring modularity. We investigate these predictions by characterizing the trophic network of a species-rich Amazonian snake community (62 species). Our results revealed an intricate network pattern resulting from larger species feeding on higher diversity of prey and therefore promoting nestedness, whereas snakes with specific lifestyles and feeding on distinct resources, promoting modularity. Species removal simulations indicated that the nested structure is favored mainly by the presence of five species of the family Boidae, which because of their body size and generalist lifestyles connect modules in the network. Our study highlights the particular ways traits affect the structure of interactions among consumers and resources at the community level.

ß-Caryophyllene nanoparticles design and development: Controlled drug delivery of cannabinoid CB2 agonist as a strategic tool towards neurodegeneration.

The sesquiterpene ß-caryophyllene (BCP) is a structurally singular cannabinoid and a selective agonist of the CB2 receptor, which in addition to being expressed in the CNS, is intrinsically expressed within the immune system and lacks psychoactivity. Nanoencapsulation of BCP can allow its controlled release into the CNS and intranasal administration. Thus, a protocol for nanoencapsulation of BCP was developed and optimized in order to adjust the desired bioactive content and physicochemical parameters. The formulation was assessed regarding nanoparticle size, zeta potential, morphology, pH, osmolarity, stability, and drug release kinetics in vitro. The final composition of the BCP nanoparticles presented in its organic phase (OP) Tween 20 (0.25%), BCP (0.1%), and PEG 400 (5%); and in its aqueous phase (AP) ultrapure water and poloxamer P188 (0.25%). The formulation showed to be suitable for intranasal administration, presenting pH 6.5 and osmolarity of 150 mmol/kg. The mean particle diameter was 147.2 nm, PDI 0.052, and zeta potential of -24.5. The accelerated stability test showed that nanoparticles were stable for up to 1 month, when reversible creaming effect occurred. Besides, it was noted a low rate of particle accumulation and particle size distribution remained unchanged. BCP nanoparticles were shown to be promptly released in physiological medium (up to 60 min). In this work, a formulation containing ß-caryophyllene nanoparticles suitable for physiological administration and preclinical tests was successfully developed.

Polyvinyl alcohol-based electrospun matrix as a delivery system for nanoemulsion containing chalcone against Leishmania (Leishmania) amazonensis.

Cutaneous leishmaniasis is a worldwide public health problem. Conventional therapies, in addition to the high cost, have many adverse effects and cases of parasite's resistance. Chalcones are secondary metabolites precursors in the flavonoid pathway and can be obtained naturally, but with low yield from plant raw material. Thus, the use of synthetic chalcones has been a promising strategy for the development of molecules with leishmanicidal activity. Thus, this work aimed to develop a controlled release system of two synthetic chalcone (trans-chalcones and 3'-(trifluormethyl)-chalcone) using polyvinyl alcohol nanofibers (PVA) as scaffold. The association of chalcones to the nanofibers was made by nanoemulsions (NE) thereof, i.e., a colloidal system on a nanometric scale, which allows compounds with opposite polarities to remain miscible and stable throughout their manipulation. Chalcone nanoemulsions were developed using the spontaneous emulsification technique. The NE were characterized regarding their particle size, polydispersion index (PDI), and zeta potential. The results showed NE with spherical shape, absolute values of zeta potential were higher than 30 mV and homogeneous distribution pattern (PDI < 0.3). Dynamics light scattering (DLS) analysis showed similar hydrodynamic rays, i.e., 180 nm (trans-chalcone NE) and 178 nm (NE containing 3'-(trifluormethyl)-chalcone, in addition to presenting encapsulation efficiency values close to 100 %. Subsequently, the NE were added to a polymeric solution of polyvinyl alcohol (PVA) and processed via the electrospinning technique affording a PVA matrix (15 %, w/v) nanofiber containing the chalcones NE at 1 mg.mL-1. In a follow-up experiment, the skin permeation assay of the PVA matrix-chalcone NE was performed in vitro using Franz type diffusion cells and porcine ear as biological model of study. The results showed that the treatments with the nanofibers containing the chalcone NE were retained mainly in the stratum corneum, while the NE suspensions containing chalcone were retained in the epidermis and dermis. This result is thought to be relevant, since parasites are located mainly in the dermis. Further, in vitro assay against the amastigote form of L. (L) amazonensis, showed IC50 values to trans-chalcone and 3'-(trifluormethyl)-chalcone of 24.42 ± 6.76 µg.mL-1 and 15.36 ± 4.61 µg.mL-1, respectively. In addition to improving the solubility of the compounds tested in culture medium without using organic solvents, chalcones in nano-emulsified form reduced the IC50 to 9.09 ± 1.24 µg.mL-1 (trans-chalcone) and 10.27 ± 2.27 µg.mL-1 (3'-(trifluormethyl)-chalcone) which confirmed the potential of the nanoemulsion containing chalcone for cutaneous leishmaniasis treatment.

Novel Dihydropyrimidinone-Derived Selenoesters as Potential Cytotoxic Agents to Human Hepatocellular Carcinoma: Molecular Docking and DNA Fragmentation.

BACKGROUND AND OBJECTIVE: Evidence point out promising anticancer activities of Dihydropyrimidinones (DHPM) and organoselenium compounds. This study aimed to evaluate the cytotoxic and antiproliferative potential of DHPM-derived selenoesters (Se-DHPM), as well as their molecular mechanisms of action. METHODS: Se-DHPM cytotoxicity was evaluated against cancer lines (HeLa, HepG2, and MCF-7) and normal cells (McCoy). HepG2 clonogenic assay allowed verifying antiproliferative effects. The propidium iodide/ orange acridine fluorescence readings showed the type of cell death induced after treatments (72h). Molecular simulations with B-DNA and 49H showed docked positions (AutoDock Vina) and trajectories/energies (GROMACS). In vitro molecular interactions used CT-DNA and 49H applying UV-Vis absorbance and fluorescence. Comet assay evaluated DNA fragmentation of HepG2 cells. Flow cytometry analysis verified HepG2 cell cycle effects. Levels of proteins (ß-actin, p53, BAX, HIF-1α, γH2AX, PARP-1, cyclin A, CDK-2, and pRB) were quantified by immunoblotting. RESULTS: Among Se-DHPM, 49H was selectively cytotoxic to HepG2 cells, reduced cell proliferation, and increased BAX (80%), and p53 (66%) causing apoptosis. Molecular assays revealed 49H inserted in the CT-DNA molecule causing the hypochromic effect. Docking simulations showed H-bonds and hydrophobic interactions, which kept the ligand partially inserted into the DNA minor groove. 49H increased the DNA damage (1.5 fold) and γH2AX level (153%). Besides, treatments reduced PARP-1 (60%) and reduced pRB phosphorylation (21%) as well as decreased cyclin A (46%) arresting cell cycle at the G1 phase. CONCLUSION: Together all data obtained confirmed the hypothesis of disruptive interactions between Se-DHPM and DNA, thereby highlighting its potential as a new anticancer drug.

Development of nanoparticles coated with cassava bagasse pectin (Manihot esculenta Crantz) containing ß-carotene for mucoadhesive applications.

Pectin (PC) extracted from a solid residue from cassava roots (Manihot esculenta Crantz) was used to coat nanoparticles (NP) containing ß-carotene (BC) aiming at the gastrointestinal administration of this lipophilic nutraceutical. The NP were prepared by spontaneous emulsification method using food grade components. Pectin-coated NP have been successfully prepared as confirmed by the increased particle size and negative surface charges due to the pectin's anionic nature. NP showed spherical shape and monodisperse distribution, with a mean size of 21.3 nm (polydispersity index (PDI) 0.29) for BC PC T80-NP (nanoparticle with ß-carotene, pectin and Tween 80) and 261.4 nm (PDI 0.1) for BC PC T20-NP (nanoparticle with ß-carotene, pectin and Tween 20). BC was encapsulated at amounts of 530 and 324 µg/ml for BC PC T80-NP and BC PC T20-NP, respectively, with high encapsulation efficiency (> 95%), increasing its antioxidant capacity in vitro, besides no cytotoxic effect. However, only BC PC T20-NP was stable over a 90 days storage period (4°C) and revealed a strong interaction between pectin and mucin. These results suggest that pectin-coated BC PC T20-NP is a promising strategy to improve the bioavailability and permeation of BC for administration through mucosal surfaces.

O que sabemos sobre neurociências?: conceitos e equívocos entre o público geral e entre educadores / What do we know about neurosciences?: Concepts and misunderstandings between the general public and between educators

As descobertas sobre o funcionamento do cérebro, assim como suas aplicações nos processos de ensino-aprendizagem, têm sido alvo de interesse. Contudo, os resultados de pesquisas e os conceitos na área das neurociências muitas vezes são mal compreendidos ou distorcidos, perpetuando-se como falsas crenças, chamados 'neuromitos'. O objetivo deste estudo foi investigar o conhecimento do público geral e, especialmente, de uma subamostra de educadores brasileiros acerca de conceitos e crenças equivocadas sobre neurociências. Trata-se de um estudo exploratório-descritivo em que participaram 2795 sujeitos, 1643 educadores (58,8%) e 1152 não educadores, que responderam a um questionário on-line sobre conceitos e equívocos em neurociências. Os resultados mostraram que tanto público geral como a subamostra de educadores, independentemente de terem feito algum curso sobre neurociências, possuem pouco conhecimento sobre o tema e apresentam crenças equivocadas em diversos conceitos. Os percentuais de erros/incertezas do público geral e da subamostra de educadores foram, respectivamente: 1) sono como momento de descanso para o cérebro (90% e 90,3%); 2) diferenças de dominância hemisférica como determinantes do desempenho em diferentes áreas (74,8% e 73,6%); 3) sentimentos vivenciados pelo coração (78,3% e 73%); 4) não maleabilidade das habilidades cognitivas (78,9% e 73,9%); e 5) uso de apenas 10% do cérebro (73,5% e 75,8%). Constata-se a necessidade de maior aproximação das neurociências com o público geral e, especialmente, com a educação e sugere-se que áreas como a Psicopedagogia e a neuropsicologia sejam facilitadoras deste processo. Ao lado disso, neurocientistas podem buscar estratégias mais eficazes de divulgação do conhecimento.

The discoveries about the functioning of the brain, as well as its applications in the teaching-learning processes, have been of interest. However, research results and concepts in the field of neuroscience are often misunderstood or distorted, perpetuating themselves as false beliefs, called 'neuromyths'. The aim of this study was to investigate the knowledge of the Brazilian general public and, especially, of a subsample of educators about conceptions and misconceptions about neuroscience. This is an exploratory-descriptive study in which 2795 subjects participated, 1643 educators (58.8%) and 1152 non-educators, who answered an online questionnaire about concepts and misunderstandings in neurosciences. The results showed that both the general public and the subsample of educators, regardless of having taken a course in neuroscience, have little knowledge on the subject and have mistaken beliefs in several concepts. The percentage of errors/uncertainties in the general public and in the educators subsample were, respectively: 1) sleep as a resting moment for the brain (90% and 90.3%); 2) differences in hemispheric dominance as determinants of performance in different areas (74.8% and 73.6%); 3) feelings experienced by the heart (78.3% and 73%); 4) non-malleability of cognitive skills (78.9% and 73.9%); and 5) use of only 10% of the brain (73.5% and 75.8%). There is a need to bring neurosciences closer to the general public, and especially to education, and it is suggested that areas such as Psychopedagogy and neuropsychology could facilitate this process. In addition, neuroscientists may seek more effective strategies for disseminating knowledge.

Carbon Monoxide and Cyanide Intoxication: An Association to Remember.

Carbon monoxide and cyanide are toxins that induce cellular hypoxia; both can be produced in the context of domestic fires and may have a synergistic effect. We present the case of a man, victim of a house fire, who was initially diagnosed as having carbon monoxide poisoning, but that afterwards also presented signs and symptoms compatible with cyanide poisoning. He was successfully treated with an antidote. We want to highlight this relatively frequent association of poisonings and the need for urgent empirical treatment.

O monóxido de carbono e o cianeto são toxinas que induzem hipóxia celular; ambos podem ser produzidos em contexto de incêndios domésticos e podem exercer um efeito tóxico sinérgico. Apresentamos o caso de um homem, vítima de incêndio doméstico, que foi inicialmente diagnosticado como intoxicação por monóxido de carbono, mas que posteriormente apresentou também sinais e sintomas compatíveis com intoxicação por cianeto, tendo sido tratado com sucesso com antídotos dirigidos. Pretendemos alertar para esta associação de intoxicações relativamente frequente e para a necessidade de tratamento empírico urgente.

Operative Hysteroscopy Intravascular Absorption Syndrome: The Gynaecology's TURP Syndrome-A Case Report.

INTRODUCTION: Operative hysteroscopy intravascular absorption (OHIA) syndrome is caused by intravascular absorption of fluid distension/irrigation medium during hysteroscopy. There are very few reported cases of this syndrome using saline as irrigation fluid. The current report was on a case of severe OHIA syndrome that necessitated resuscitation in an intensive care unit (ICU). CASE PRESENTATION: A 41-year-old, 65-kg, smoker female patient was admitted for an endoscopic resection of submucous uterine myoma under general anesthesia using a laryngeal mask airway. In the 50th minute of the procedure, end-tidal CO2 dropped from 35 to 25 mmHg and pulse oximetry (SpO2) from 100% to 90%. Crackling sounds were heard from the base of the lungs. As a pulmonary oedema was suspected, the volume of irrigated saline was checked. A total of 4000 of the total 9000 mL of the saline had been absorbed into intravascular compartment. She developed a severe metabolic acidosis (pH 7.09) with severe hypokalemia (K+ 2.3 mEq/L), hypocalcaemia (Ca2+ 0.76 mEq/L), anemia (hemoglobin 5.3 g/dL), and hypothermia (tympanic temperature 33°C), as well as a generalized oedema with pulmonary and airway oedema. Due to airway oedema, she could only be intubated with a 6.5-mm tracheal tube. Resuscitation in the ICU was required. Electrolyte disturbances were corrected and furosemide was administered. She had a full recovery after 24 hours and 48 hours later, she was discharged. CONCLUSIONS: Absorption of the irrigation fluid can result in life-threatening fluid overload. Accurate fluid balancing and limiting the operation time may prevent such complications. Therefore, early diagnosis and treatment of this syndrome is emphasized.

Cognitive performance in patients with cerebral arteriovenous malformation.

OBJECTIVE: A cerebral arteriovenous malformation (cAVM) can change over time and cause symptoms, but clinical studies tend to define only the patients with ruptured cAVMs as symptomatic and do not consider neurocognitive aspects prior to neurosurgical intervention. The objective of this study was to describe the neurocognitive function of patients with ruptured and unruptured cAVMs according to the Spetzler-Martin (SM) grade, flow status, and anatomical topography. METHODS: In this blinded cross-sectional study, 70 patients of both sexes and ages 18-60 years were evaluated using the Brazilian Brief Neuropsychological Assessment Battery Neupsilin. RESULTS: Of the 70 patients with cAVMs, 50 (71.4%) demonstrated deficits in at least one of the eight neurocognitive domains surveyed, although they did not exhibit neurological deficits. cAVMs in the temporal lobe were associated with memory deficits compared with the general population. The SM grade was not significantly associated with the results of patients with unruptured cAVMs. However, among patients with ruptured cAVMs, there were deficits in working memory in those with high-grade (SM grade) cAVMs and deficits in executive function (verbal fluency) in those with low-grade cAVMs (p < 0.001). CONCLUSIONS: This study indicates that patients with untreated cAVMs, either ruptured or unruptured, already exhibit neurocognitive deficits, even the patients without other neurological symptoms. However, the scales used to evaluate disability in the main clinical studies, such as A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA), do not assess neurocognitive alterations and therefore disregard any deficits that may affect quality of life. The authors' finding raises an important question about the effects of interventional treatment because it reinforces the hypothesis that cognitive alterations may be preexisting and not determined by interventions.

Can MoCA and MMSE Be Interchangeable Cognitive Screening Tools? A Systematic Review.

BACKGROUND AND OBJECTIVES: Cognitive disorders may be an early sign of neuropsychiatric disorders; however, it remains unclear whether the screening measures are interchangeable. The aim of this study was to contrast the most commonly used screening tools-Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)-for early detection of neurocognitive disorder (NCD). RESEARCH DESIGN AND METHODS: This study presents a descriptive systematic review and informative literature according to the Cochrane Foundation's guidelines. The keywords "Mini-Mental State Examination" and "Montreal Cognitive Assessment" were searched in the Web of Science, SciELO, and LILACS databases. RESULTS: Fifty-one studies were selected including a total sample of 11,870 participants (8,360 clinical patients and 3,510 healthy controls). Most studies were published in the past 5 years using a cross-sectional design, carried out across the world. They were organized by age ranges (18-69 years and 20-89 years), years of schooling, and mental status (with and without mental and behavior disorders). Sixteen of 18 studies had participants aged 18-69 years, and 21 out of 33 studies within the older set suggested that the MoCA is a more sensitive tool for detecting NCD. DISCUSSION AND IMPLICATIONS: Thirty-seven studies suggested that the MoCA is a more sensitive tool for NCD detection because it assesses executive function and visuospatial abilities. Some individuals who demonstrated normal cognitive function on the MMSE had lower performance on the MoCA. However, it seems necessary to establish different cutoffs based on years of schooling to avoid false positives. Future studies should contrast MoCA with other screening tools designed for NCD assessment.

Nanotechnology: A Promising Tool Towards Wound Healing.

Nanotechnology is an exciting emerging field with multiple applications in skin regeneration. Nanofibers have gained special attention in skin regeneration based on their structural similarity to the extracellular matrix. A wide variety of polymeric nanofibers with distinct properties have been developed and tested as scaffolds for skin regeneration. Besides providing support for tissue repair, nanofibrous materials can act as delivery systems for drugs, proteins, growth factors, and other molecules. Moreover, the morphology, biodegradability, and other functionalities of nanofibrous materials can be controlled towards specific conditions of wound healing. Other nanostructured drug delivery systems, such as nanoparticles, micelles, nanoemulsions, and liposomes, have been used to improve wound healing at different stages. These nanoscale delivery systems have demonstrated several benefits for the wound healing process, including reduced cytotoxicity of drugs, administration of poorly water-soluble drugs, improved skin penetration, controlled release properties, antimicrobial activity, and protection of drugs against light, temperature, enzymes or pH degradation, as well as stimulation of fibroblast proliferation and reduced inflammation.