Chemical generation of checkpoint inhibitory T cell engagers for the treatment of cancer.

Bispecific T cell engagers (BiTEs), a subset of bispecific antibodies (bsAbs), can promote a targeted cancer cell's death by bringing it close to a cytotoxic T cell. Checkpoint inhibitory T cell engagers (CiTEs) comprise a BiTE core with an added immunomodulatory protein, which serves to reverse cancer-cell immune-dampening strategies, improving efficacy. So far, protein engineering has been the main approach to generate bsAbs and CiTEs, but improved chemical methods for their generation have recently been developed. Homogeneous fragment-based bsAbs constructed from fragment antigen-binding regions (Fabs) can be generated using click chemistry. Here we describe a chemical method to generate biotin-functionalized three-protein conjugates, which include two CiTE molecules, one containing an anti-PD-1 Fab and the other containing an immunomodulatory enzyme, Salmonella typhimurium sialidase. The CiTEs' efficacy was shown to be superior to that of the simpler BiTE scaffold, with the sialidase-containing CiTE inducing substantially enhanced T cell-mediated cytotoxicity in vitro. The chemical method described here, more generally, enables the generation of multi-protein constructs with further biological applications.

Advanced Levels of Chronic Venous Insufficiency are Related to an Increased in Arterial Stiffness.

BACKGROUND: Chronic venous insufficiency (CVI) is characterized by progressive inflammatory changes. Inflammatory damage occurs in the veins, adjacent tissues, and can lead to structural changes in the arteries. The aim of this study is to analyze whether the degree of CVI is associated with arterial stiffness. METHODS: Cross-sectional study including patients with CVI classified by clinical, etiological, anatomical, and pathophysiological classification (CEAP) 1 to 6. We performed correlation between the degree of CVI, central and peripheral arterial pressure, and arterial stiffness measured by brachial artery oscillometry. RESULTS: We evaluated 70 patients, 53 of whom were women with a mean age of 54.7 years. Patients with advanced degrees of venous insufficiency CEAP 4,5,6, had higher levels of systolic, diastolic, central, and peripheral arterial pressures compared to those with early stages (CEAP 1,2,3). The CEAP 4,5,6 group had higher arterial stiffness indices than the CEAP 1,2,3 group: pulse wave velocity (PWV) 9.3 m/s vs. 7.0 m/s, P < 0.001; augmentation pressure (AP) 8.0 mm Hg vs. 6.3 mm Hg; P = 0.04. There was a positive correlation between the degree of venous insufficiency measured by the venous clinical severity score, villalta score and CEAP classification, and the arterial stiffness indices (Spearman's coefficient = 0.62 for PWV and CEAP, P < 0.01). The factors influencing PWV were age, peripheral systolic arterial pressure (SAPp), and AP. CONCLUSIONS: There is a correlation between the degree of venous disease and arterial structural changes characterized by arterial pressure and stiffness indices. Degenerative changes secondary to venous insufficiency are associated with impairment of the arterial system, which has implications for the development of cardiovascular disease.

Time trend prevalence of helicobacter pylori infection and endoscopic findings in symptomatic children in Portugal: A retrospective study based on three time points in 2009, 2014, and 2019.

BACKGROUND: Helicobacter pylori infection acquisition occurs mainly in childhood and may be a critical factor in developing long-term complications. In contrast to other developed countries, previous studies have reported a relatively high H. pylori infection prevalence in Portugal, both in children and adults. However, there are no recent data concerning pediatric population. MATERIALS AND METHODS: We performed a retrospective observational study concerning an 11 years period (2009, 2014, 2019), that included patients under 18 years old who underwent upper endoscopy at a pediatric tertiary center. Demographic, clinical-pathological, and microbiological data were collected. RESULTS: Four hundred and sixty one children were included. The average age was 11.7 ± 4.4 years. In total, H. pylori infection was confirmed in 37.3% of cases (histology and/or culture) and a decreasing infection trend was observed (p = .027). The most common indication for endoscopy was abdominal pain, which was a good predictor of infection. Antral nodularity was present in 72.2% of the infected children (p < .001). In the oldest age groups, moderate/severe chronic inflammation, H. pylori density and lymphoid aggregates/follicles were positive predictors for the presence of antral nodularity. For all ages, the presence of antral nodularity, neutrophilic activity in the antrum and corpus and lymphoid follicles/aggregates in the antrum were positive predictors for the presence of H. pylori infection. Among the 139 strains tested for antibiotic susceptibility, 48.9% were susceptible to all tested antibiotics. Resistance to clarithromycin, metronidazole, and both was detected in 23.0%, 12.9%, and 6.5% of the strains, respectively; furthermore, resistance to ciprofloxacin and to amoxicillin was observed in 5.0% and 1.4% of the strains, respectively. CONCLUSIONS: The present study reports (for the first time in Portugal) a significant decreasing trend in the prevalence of pediatric H. pylori infection, although it remains relatively high compared to the recently reported prevalence in other South European countries. We confirmed a previously recognized positive association of some endoscopic and histological features with H. pylori infection, as well as a high prevalence rate of resistance to clarithromycin and to metronidazole. The clinical relevance of these findings requires confirmation with further studies at a national level, taking into account the high incidence rate of gastric cancer in Portugal and the potential need for country-specific intervention strategies.

Associação entre síndrome metabólica e rigidez arterial / Association between metabolic syndrome and arterial stiffness

Introdução: A síndrome metabólica (SM) é considerada um importante fator de risco para doenças cardiovasculares por promover mudanças biomecânicas nas paredes dos vasos que acarretam rigidez arterial (RA). Objetivo: Analisar a associação entre a síndrome metabólica e rigidez arterial. Além de descrever a população de estudo segundo características sociodemográficas e clínicas. Métodos: Estudos transversal de base populacional, na área restrita do Vale do Ogunjá, Salvador-Bahia. Foram obtidos dados sociodemográficos, por meio de questionário e dados clínicos. A VOP foi avaliada por tonometria de aplanação com o aparelho SphygmoCor® (AtCor Medical Pty Ltd, New South Wales, Austrália). Foram obtidas medidas de frequência e descritivas de central e dispersão, e o teste Qui-quadrado para análise estatística. Resultados: A VOP alterada foi mais prevalente em indivíduos que foram diagnosticados com a síndrome metabólica (37,2%), com uma razão de prevalência 2,0 vezes maiores quando comparados aos indivíduos hígidos (IC95%: 0,86 ­ 4,45). Houve também maior prevalência da RA no sexo masculino (30,4%), na faixa etária entre 40 a 74 anos (38,7%), em autodeclarados preto/pardo (27,4%), em divorciados/viúvos (38,9%) e com baixo nível de escolaridade (38,5%). As diferenças proporcionais entre os indivíduos com e sem rigidez arterial foram estatisticamente significantes entre as variáveis escolaridade (p=0,022), faixa etária (p=0,001) e hipertensão arterial (p=0,000). Por outro lado, não foram encontradas diferenças proporcionais estatisticamente significantes (p>0,05) entre as variáveis sexo, cor e estado civil, assim como para a síndrome metabólica e as variáveis que fazem parte da sua definição (hipertrigliceridemia, HDL, glicemia de jejum e obesidade abdominal), com exceção da hipertensão arterial. Conclusão: Apesar da maior prevalência de rigidez arterial em indivíduos com síndrome metabólica, não foi encontrada uma associação estatisticamente significante entre essas duas variáveis. Foi possível verificar uma associação estatisticamente significante entre a hipertensão arterial, indivíduos com idade mais avançada e com baixo nível de escolaridade e a rigidez arterial. (AU)

iomechanical changes in the walls of the vessels that cause arterial stiffness (AR). Objetive: Analyze the association between Metabolic Syndrome (MS) and arterial stiffness and to characterize the study population according to sociodemographic and clinical characteristics. Methods: Cross-sectional population-based studies, in the restricted area of Vale do Ogunjá, Salvador-Bahia. Sociodemographic data, through questionnaire and clinical data were obtained. A PWV was evaluated by applanation tonometry using the device SphygmoCor® (AtCor Medical Pty Ltd, New South Wales, Australia). Frequency and descriptive measurements of central and dispersion were obtained, and the Chi-square test to statistical analysis. Results: The altered PWV was more prevalent in individuals who were diagnosed with the metabolic syndrome (37.2%), with a prevalence ratio 2.0 times higher when compared to healthy individuals (95% CI: 0.86 - 4.45). There was also a higher prevalence of AR in males (30.4%), aged between 40 and 74 years (38.7%), in self-declared black / brown (27.4%), in divorced / widowed (38, 9%) and with a low level of education (38.5%). The proportional differences between individuals with and without arterial stiffness were statistically significant between the variables education (p = 0.022), age group (p = 0.001) and arterial hypertension (p = 0.000). On the other hand, there were no statistically significant proportional differences (p> 0.05) between the variables gender, color and marital status, as well as for the metabolic syndrome and the variables that are part of its definition (hypertriglyceridemia, HDL, blood glucose) fasting and abdominal obesity), with the exception of arterial hypertension. Conclusion: Despite the higher prevalence of arterial stiffness in individuals with metabolic syndrome, no statistically significant association was found between these two variables. It was possible to verify a statistically significant association between arterial hypertension, individuals with older age and with low level of education and arterial stiffness.

The Endoscopic Anatomy of the External Acoustic Meatus and of the Middle Ear in Dry Temporal Bones: A Study Conducted Using Digital and Mobile Device Technology

Abstract Introduction The endoscopic anatomy of the middle ear (ME) and of the external acoustic meatus (EAM) has been described in cadavers, in fresh temporal bones, or in vivo using conventional video recording, but not in dry bones or using an alternative inspection and recording technique. Objective To study the anatomy of the ME and of the EAM in dry temporal bones using a smartphone-endoscope system. Methods The EAM and the ME were studied in dry temporal bones using an endoscopic transcanal approach with a telescope connected to a smartphone (M-scope mobile endoscope app and adaptador, GBEF Telefonia, São Paulo, SP, Brazil). Results Out of 50 specimens, 2 had exostosis of the EAM and 3 contained remains of the tympanic membrane. The anterior wall of the EAM was prominent in 10/48 specimens (20.8%). Ossicles were seen in 13/45 (28.8%), stapes at the oval window were seen in 12/45 (26.6%), and the incus was seen in 1/45 (2.2%) specimens. The facial canal was open and protruding in 15/45 (33.3%) and in 7/45 (15.5%) specimens, respectively. Of the 45 MEs evaluated, type A was predominant for finiculus (93.3%), subiculum (100%), and ponticulus (95.6%). The rest were type B. None was classified as type C. According to its position in relation to the round window, the fustis was classified into type A (68.9%) or B (31.1%). The pyramidal eminence, the bony portion of the Eustachian tube, the semicanal of the tensor tympani muscle, and the cochleariform process were visualized completely or partially in all cases. Conclusion The use of a smartphone-based endoscopic transcanal procedure in dry temporal bones allowed the evaluation of anatomical variations in the EAM and in the ME.

The Endoscopic Anatomy of the External Acoustic Meatus and of the Middle Ear in Dry Temporal Bones: A Study Conducted Using Digital and Mobile Device Technology.

Introduction The endoscopic anatomy of the middle ear (ME) and of the external acoustic meatus (EAM) has been described in cadavers, in fresh temporal bones, or in vivo using conventional video recording, but not in dry bones or using an alternative inspection and recording technique. Objective To study the anatomy of the ME and of the EAM in dry temporal bones using a smartphone-endoscope system. Methods The EAM and the ME were studied in dry temporal bones using an endoscopic transcanal approach with a telescope connected to a smartphone (M-scope mobile endoscope app and adaptador, GBEF Telefonia, São Paulo, SP, Brazil). Results Out of 50 specimens, 2 had exostosis of the EAM and 3 contained remains of the tympanic membrane. The anterior wall of the EAM was prominent in 10/48 specimens (20.8%). Ossicles were seen in 13/45 (28.8%), stapes at the oval window were seen in 12/45 (26.6%), and the incus was seen in 1/45 (2.2%) specimens. The facial canal was open and protruding in 15/45 (33.3%) and in 7/45 (15.5%) specimens, respectively. Of the 45 MEs evaluated, type A was predominant for finiculus (93.3%), subiculum (100%), and ponticulus (95.6%). The rest were type B. None was classified as type C. According to its position in relation to the round window, the fustis was classified into type A (68.9%) or B (31.1%). The pyramidal eminence, the bony portion of the Eustachian tube, the semicanal of the tensor tympani muscle, and the cochleariform process were visualized completely or partially in all cases. Conclusion The use of a smartphone-based endoscopic transcanal procedure in dry temporal bones allowed the evaluation of anatomical variations in the EAM and in the ME.

Assessment of Functional Outcome Predictors in Patients Undergoing Lumbar Interbody Fusion Surgery: A Single-Centre Analysis.

Introduction Lumbar interbody fusion is a surgical modality performed in selected patients with low back and radicular pain not responding to medical therapy. We aim to evaluate the main predictors of functional outcome, assessed through Oswestry Disability Index (ODI), in patients submitted to a lumbar interbody fusion. Methods A sample of 33 patients undergoing lumbar interbody fusion at a neurosurgery department between 2017 and 2020 was selected. In order to assess functional status, ODI was applied before and after surgery. Data related to patients' medical history, current disease, and surgery performed were collected from the clinical process. Results In our cohort, functional improvement (pre-surgery ODI - post-surgery ODI) averaged 34.4 ± 23 points, suggesting robust surgical efficacy. We find patients with severe disability or worse to display relevant amelioration of their functional scores (p<0.0001), suggesting that these can benefit from lumbar interbody fusion surgery. The female gender (p=0.007) predicts a better outcome, which was surprising as no sex differences in lumbar fusion outcomes have been reported. Conversely, early symptom recurrence (p=0.015) and need for revision surgery (p=0.032) were found to be negative predictors of post-surgical functional outcome. Rapid return to the activities of daily living (p=0.001) and to work (p=0.002) was associated with post-surgical functional improvement. The underlying diagnosis that led to surgical referral and surgical modality did not affect the functional outcome in our patient cohort. Importantly, patients with previous lumbar surgeries had similar improvements to those who had never been operated on. Conclusions Severely disabled patients submitted to lumbar interbody fusion showed significant functional improvement, regardless of the referral diagnosis or the existence of previous lumbar surgeries. Additionally, sustained functional improvement resulted in a return to an active life.

Vestibular Schwannoma Leading to Contacting Aneurysm Rupture: An Unusual Presentation.

Subarachnoid hemorrhage (SAH) is a rare manifestation of brain tumors, being even rarer in vestibular schwannomas. We report the second case of a posterior circulation aneurysm close to the tumor capsule, responsible for SAH as an initial manifestation of a vestibular schwannoma. A 67-year-old female was admitted to the Emergency Department with sudden onset of nausea and headache. A diagnosis of a SAH and a tumor of the right cerebellopontine angle was made. An angiography showed an aneurysm in the dependency of the right anterior inferior cerebellar artery (AICA), juxtaposed to the tumor capsule. The patient underwent surgery, the tumor was removed, and the aneurysm was treated. This case highlights that SAH in patients with vestibular schwannoma may originate from a contact aneurysm. Although exceedingly rare, surgeons should consider this scenario in vestibular schwannoma presenting with SAH, and angiography is important for its diagnosis.

A Framework and a Research Design Proposal to Identify Preservice Teachers' Integration Performance of Science and Mathematics.

Integration is an important, albeit difficult, goal of science and mathematics education. This paper presents a framework and a research design proposal to identify preservice teachers' (PSTs) integration performance of science and mathematics (IPoSM). It also presents the classification of PSTs' level of integration in each phase of a problem-based learning (PBL) activity, within the proposed framework, and evidence of their work. The framework is organized in three levels of integration, based on current research, and detailed with specific integration indicators about an exemplary PBL activity, named STEM Bees. This PBL activity was structured as a research problem divided into two integrated problems. A qualitative methodology was used, focused on the application of the framework to the work of PSTs in that PBL activity. The final participants were 13 PSTs, organized in four working groups. In general, results show that PSTs' integration performance was higher with the second problem than with the first problem. However, full integration with meaningful connections between science and mathematics ideas was achieved by almost all PST at the conclusion of the research problem. The IPoSM framework indicators proved to be useful for identifying the level of integration of science and mathematics in PSTs' work in each phase of the PBL activity. Keeping the IPoSM framework in mind, teacher educators could elaborate more effective problem-based integrated approaches of science and mathematics in initial teacher education.

Bien que difficile à réaliser, l'intégration constitue un objectif important de l'enseignement des sciences et des mathématiques. Cet article présente un cadre ainsi qu'un projet conceptuel de recherche destinés à déterminer le rendement des enseignants en formation initiale (EFI) dans leur processus d'intégration des sciences et des mathématiques (RdISM). On y présente aussi la catégorisation du niveau d'intégration des EFI dans chacun des stades d'une activité d'apprentissage par résolution de problèmes (ARP), à l'intérieur du cadre proposé ainsi que des preuves de leur travail. En accord avec la recherche en cours, on a organisé le cadre en trois niveaux d'intégration comprenant des indicateurs d'intégration précis applicables à une activité type d'ARP nommée « Abeilles STEM¼. Cette activité d'ARP était conçue de façon à agir comme problématique de recherche que l'on a divisée en deux enjeux intégrés. On a utilisé une méthode qualitative ciblée sur la mise en application du cadre au travail réalisé par les EFI lors de cette activité d'ARP. La liste finale des participants comprenait 13 EFI placés dans quatre groupes de travail. En général, les résultats montrent un rendement en intégration de la part des EFI plus élevé dans le deuxième enjeu que dans le premier. Toutefois, l'intégration complète comprenant l'établissement de liens étroits entre les concepts scientifiques et mathématiques a été atteinte par presque tous les EFI au terme de la problématique de recherche. Les indicateurs du cadre de RdISM ont démontré leur utilité pour déterminer le niveau d'intégration en sciences et en mathématiques dans le travail des EFI pour chacun des stades de l'activité d'ARP. En tenant compte du cadre de RdISM, les formateurs d'enseignants pourraient concevoir des approches d'intégration fondées sur la résolution de problèmes plus efficaces en sciences et en mathématiques dans la formation initiale des enseignants.

Cannabinoid Hyperemesis Syndrome: A Case Report of an Underdiagnosed Condition.

Cannabinoid hyperemesis syndrome (CHS) is characterized by episodic bursts of nausea, vomiting and abdominal pain, affecting chronic cannabis users. The clinical picture mimics an acute abdomen, usually leading to multiple assessments in the emergency department. Several complementary diagnostic examinations are performed with non-specific results, making differential diagnosis puzzling. We present a case of a 42-year-old man, who has been admitted multiple times to the emergency department in the last 3 months for abdominal pain, nausea and vomiting, without triggering factors and improving only with hot water baths. He was evaluated by different specialties, the various complementary diagnostic tests performed showed no significant results, and no definitive diagnosis was obtained. Treatment resulted only in a partial and transient resolution of symptoms. A more detailed medical history revealed cannabis use for more than 5 years, with a recent increase in the amount consumed. After psychoeducation, explaining the risks associated with consumption and its relationship with the clinical symptoms, which resulted in complete suspension of cannabis, there have been no new symptomatic episodes since then. We present an illustrative case of a poorly reported clinical entity despite having a probable significant prevalence, raising awareness in order that clinicians identify and properly manage these cases.

A Síndrome Hiperemética dos Canabinóides cursa com crises episódicas de náuseas, vómitos e dor abdominal que acometem consumidores crónicos de cannabis. O quadro clínico mimetiza o de um abdómen agudo, condicionando habitualmente múltiplas avaliações no Serviço de Urgência (SU) que levam à realização de vários exames complementares de diagnóstico (ECD), cujos resultados tendem a ser inespecíficos, dificultando o diagnóstico diferencial. Apresentamos o caso de um homem de 42 anos de idade, sem antecedentes psiquiátricos conhecidos, que nos últimos 3 meses foi admitido por múltiplas vezes no SU Hospitalar por dor abdominal, náuseas e vómitos aliviados com banhos de água quente. Vários exames auxiliares de diagnóstico e avaliação por diferentes especialidades foram realizados, sem que se obtivesse um diagnóstico definitivo. A terapêutica sintomática instituída resultou apenas numa resolução parcial e transitória dos sintomas. Uma história clínica mais detalhada revelou um consumo de cannabis há mais de 5 anos, com incremento recente da quantidade consumida. Após psicoeducação ao doente, explicando os riscos do consume de canabinóides e a sua relação com a sintomatologia apresentada resultou na suspensão completa no consume de cannabis, não se tendo verificado novos episódios sintomáticos desde então. Este é um caso ilustrativo de uma entidade clínica recente, cuja prevalência está a aumentar, tendo em conta o aumento do consumo de cannabis. A adequada identificação desta patologia é fundamental para um tratamento adequado e eficaz, evitando o uso desnecessário de métodos complementares de diagnóstico e medicação.

When Paranoia Comes with the Treatment: Psychosis Associated with Tacrolimus Use.

Tacrolimus is an immunosuppressive drug frequently used in solid organ transplant recipients. This drug has well-documented neuropsychiatric side effects in the literature, although emergence of psychotic symptoms is rare, being only described in a very few case reports. We present a case of a renal transplant recipient with no prior psychiatric history, who developed a severe psychosis secondary to supratherapeutic tacrolimus' blood concentrations. This case highlights the importance of clinical awareness to rare but severe neuropsychiatric effects due to tacrolimus use.

Correction: A synopsis of Salvatoria McIntosh, 1885 (Annelida: Syllidae: Exogoninae) from Brazilian coastal and oceanic waters.

[This corrects the article DOI: 10.1371/journal.pone.0250472.].

Psychoactive substance consumption: A Portuguese cross-sectional study.

BACKGROUND: Increasing consumption of psychoactive substances is a major social concern worldwide. OBJECTIVES: To investigate the prevalence of psychoactive substances consumption in the Portuguese, throughout their life as well as recently, and the main reasons for the consumption and associated factors. METHODS: This cross-sectional study was based on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) applied to a sample of 385 Portuguese obtained for convenience. It was used descriptive statistics, the Cui-square, Mann-Whitney U and Kruskal-Wallis tests, with a significance level of 5%. RESULTS: Alcohol was the most consumed throughout life (86%), followed by xanthines (79%) and tobacco (60%). In the last 3 months, xanthines (49%) were the most consumed daily, followed by tobacco (22%) and alcohol (9%). Socializing was the main reason for consumption of alcohol (67%), tobacco (36%) and cannabis (34%) while anxiolytics have been used to sleep (50%) and xanthines to increase cognitive capacity (35%). Tobacco (p = 0.016), alcohol (p = 0.03) and illicit substances (p < 0.001) were more consumed by men and anxiolytics by women (p = 0.027). Alcohol (p = 0.008), cannabis (p = 0.027), and xanthines (p = 0.009) were mostly consumed by young adults. CONCLUSIONS: The results reveal sporadic and recreational use of illicit substances, and regular use of alcohol, tobacco and xanthines, mostly by young adults and men, and anxiolytics by women. Socializing was the main reason for psychoactive substances consumption.

International Survey of Operative Practices for Otologists and Neurotologists During the COVID-19 Crisis.

OBJECTIVE: To investigate the influence of the COVID-19 pandemic on operative practices of otology and neurotology providers internationally. STUDY DESIGN: Cross-sectional survey. METHODS: A 78-question survey was distributed to otologists and neurotologists between May 12, 2020 and June 8, 2020 to assess the impact of the pandemic on surgical practices. Sections within the survey delineated time periods: prior to the crisis, onset of the crisis, during the crisis, postcrisis transition. RESULTS: Of 396 survey respondents, 284 participants from 38 countries met inclusion criteria.Respondents were 16.9% female and 82.4% male, with a most common age range of 40 to 49 years (36.3%). 69.8% of participants had been in practice for over 10 years and most respondents worked in an academic medical center (79.2%). The average operative weekly caseload was 5.3 (SD 3.9) per surgeon prior to the crisis, 0.7 (SD 1.2) during the COVID-19 crisis, and 3.5 (SD 3.3) for those who had begun a postcrisis transition at the time of survey administration (p < 0.001). 71.5% of providers did not perform an elective otologic or neurotologic operative procedure during the initial crisis period. 49.8% reported modifying their surgical technique due to the COVID-19 pandemic. Use of powered air-purifying respirators and filtering facepiece 2 or 3 (FFP2/FFP3) respirators were in minimal supply for 66.9% and 62.3% of respondents, respectively. CONCLUSION: The COVID-19 pandemic impacted the otology and neurotology community globally, resulting in significant changes in operative volume and case selection. Modification of surgical technique and shortages of personal protective equipment were frequently reported.

Employing defined bioconjugates to generate chemically functionalised gold nanoparticles for in vitro diagnostic applications.

Novel methods for introducing chemical and biological functionality to the surface of gold nanoparticles serve to increase the utility of this class of nanomaterials across a range of applications. To date, methods for functionalising gold surfaces have relied upon uncontrollable non-specific adsorption, bespoke chemical linkers, or non-generalisable protein-protein interactions. Herein we report a versatile method for introducing functionality to gold nanoparticles by exploiting the strong interaction between chemically functionalised bovine serum albumin (f-BSA) and citrate-capped gold nanoparticles (AuNPs). We establish the generalisability of the method by introducing a variety of functionalities to gold nanoparticles using cheap, commercially available chemical linkers. The utility of this approach is further demonstrated through the conjugation of the monoclonal antibody Ontruzant to f-BSA-AuNPs using inverse electron-demand Diels-Alder (iEDDA) click chemistry, a hitherto unexplored chemistry for AuNP-IgG conjugation. Finally, we show that the AuNP-Ontruzant particles generated via f-BSA-AuNPs have a greater affinity for their target in a lateral flow format when compared to conventional physisorption, highlighting the potential of this technology for producing sensitive diagnostic tests.

A synopsis of Salvatoria McIntosh, 1885 (Annelida: Syllidae: Exogoninae) from Brazilian coastal and oceanic waters.

We compiled the records for the genus Salvatoria from Brazilian coastal and oceanic habitats, collected by several projects along the years. Here we present 12 species, eight of which already reported-S. breviarticulata comb. nov., S. clavata, S. euritmica, S. heterocirra, S. limbata, S. longiarticulata comb. nov., S. neapolitana and S. cf. nitidula-with comments regarding the confidence of some of these records. We also describe three new species, S. marielleae n. sp. and Salvatoria nitiduloides n. sp., based on material from Fernando de Noronha and Trindade islands, off the Northeastern Brazilian coast, and S. ypsiloides n. sp., from Fernando de Noronha and also, Campos Basin, off Southeastern Brazilian coast, in depths down to 970 m. Finally, we report a probably undescribed species, Salvatoria sp., represented by only one specimen lacking median antenna, preventing us to proceed with further identification properly. A dichotomous identification key and a comparative table with morphological data of specimens belonging to these species are also provided.

COVID-19 and ear endoscopy in otologic practices.

PURPOSE: Otolaryngologists have had to postpone the majority of surgical procedures in the current COVID-19 pandemic. Airborne transmission, beyond the projection of droplets from upper airways, expose healthcare workers to a risk of viral infection. Aerosol generating procedures (AGP) increase the risk of viral transmission to staff within the operating room. METHODS: Surgery of middle ear and mastoid is also considered an AGP, particularly mastoidectomy performed using a high-speed drill. The authors report their experience in endoscopic ear surgery as an alternative technique to reduce AGP in otologic procedures. RESULTS: Transcanal endoscopic ear surgery is a reliable technique used to manage many otologic conditions. CONCLUSION: The endoscopic approach may reduce the risk of viral transmission to operating room staff by reducing the need for mastoidectomy.

Future of Endoscopic Ear Surgery.

Endoscopic ear surgery has gained popularity in recent years, becoming standard practice in otology centers around the world as an adjunct to conventional microscopic surgery and as a sole tool for limited disease. During the last years, technical improvements and growing expertise in the handling of the endoscope allowed introducing an exclusive endoscopic approach to the middle ear, lateral skull base, middle cranial fossa, and posterior fossa/cerebellopontine angle pathologies. Endoscopic instrumentation, techniques, and knowledge have improved during the last few years, and in the future, endoscopic surgical techniques will gain even more importance in otologic surgery.

Mind Health Before and After Total Knee Arthroplasty.

Objective To assess the preoperative and postoperative outcomes of patients diagnosed with severe knee osteoarthritis who underwent a total knee arthroplasty (TKA) using a mobile-bearing implant with a rotating platform and removing the posterior cruciate ligament. The present study focused on the outcomes relative to depression, pain, functional limitations, and fall episodes. Methods The Lequesne questionnaire was used to assess pain and functional limitations before and after TKA. In addition, the geriatric depression scale (GDS) was also used. Episodes of falls before and after the surgery were estimated. Results The mean Lequesne score before the surgery was 15.95, and that after surgery was 6.5. This finding was statistically significant ( p < 0.001). The mean GDS score before the surgery was 7.43, and that after TKA was 2.22 ( p < 0.001). The mean number of fall occurrences before the procedure, over a 1-year period, was 1.22, and that after TKA was 0.27 ( p = 0.004). A direct relationship was found between the Lequesne scores before the surgery and the GDS scores ( p = 0.004). Conclusions Total knee arthroplasty resulted in the improvement of pain and functional limitation, decrease or disappearance of the depressive condition, and decrease of fall rates in the evaluated patients.