The Association Between Oncology Outreach and Timely Treatment for Rural Patients with Breast Cancer: A Claims-Based Approach.

BACKGROUND: Oncology outreach is a common strategy for increasing rural access to cancer care, where traveling oncologists commute across healthcare settings to extend specialized care. Examining the extent to which physician outreach is associated with timely treatment for rural patients is critical for informing outreach strategies. METHODS: We identified a 100% fee-for-service sample of incident breast cancer patients from 2015 to 2020 Medicare claims and apportioned them into surgery and adjuvant therapy cohorts based on treatment history. We defined an outreach visit as the provision of care by a traveling oncologist at a clinic outside of their primary hospital service area. We used hierarchical logistic regression to examine the associations between patient receipt of preoperative care at an outreach visit (preoperative outreach) and > 60-day surgical delay, and patient receipt of postoperative care at an outreach visit (postoperative outreach) and > 60-day adjuvant delay. RESULTS: We identified 30,337 rural-residing patients who received breast cancer surgery, of whom 4071 (13.4%) experienced surgical delay. Among surgical patients, 14,501 received adjuvant therapy, of whom 2943 (20.3%) experienced adjuvant delay. In adjusted analysis, we found that patient receipt of preoperative outreach was associated with reduced odds of surgical delay (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.61-0.91); however, we found no association between patient receipt of postoperative outreach and adjuvant delay (OR 1.04, 95% CI 0.85-1.25). CONCLUSIONS: Our findings indicate that preoperative outreach is protective against surgical delay. The traveling oncologists who enable such outreach may play an integral role in catalyzing the coordination and timeliness of patient-centered care.

Exercises for the prevention of non-specific low back pain.

OBJECTIVES: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effects of exercise alone or exercise plus education compared with inactive control or education alone to prevent non-specific LBP.

Implementation of back to living well, a community-based program for the tertiary prevention of low back pain: a study protocol.

BACKGROUND: The current literature supports the effectiveness of exercise, education, and self-management interventions for the long-term management of persistent low back pain. However, there is significant uncertainty about the implementation of interventions related to barriers, facilitators, and patient's preferences. This study will evaluate the Back to Living Well program implementation from a participant and organizational perspective. More specifically we address the following objectives: 1) identify program barriers and facilitators from participants' perspectives, 2) identify factors related to program, personal and contextual factors that contribute to negative and positive outcomes, and outcome trajectories, 3) identify factors influencing participants' selection of an in-person or e-health program, and 4) evaluate program specific barriers and facilitators from the organization and care delivery perspectives. METHODS: This study will utilize a mixed-method convergent design including a longitudinal cohort strand and a longitudinal qualitative interview strand. The RE-AIM framework will be used to assess program implementation. Participants (n = 90, 1:1: in person or virtual) who choose to register in the program as well as staff (n = 10 to 15) involved in the delivery of the program will be invited to participate. Participants will participate in a 12-week physical activity, education, and self-management program. Implementation outcomes will be measured at 3-, 6-, 12-months, and six months after the end of the follow-ups. Interview scripts and directed content analysis will be constructed based on the Theoretical Domains Framework and the Neuromatrix Model of Pain, Theoretical Domains Framework. Staff interviews will be constructed and analyzed using the Consolidated Framework for Implementation Research. Participants will also complete pain, disability, quality of life and psychological questionnaires, wear an activity tracker at all time points, and complete weekly pain and activity limitation questions using a mobile application. DISCUSSION: The study results will provide evidence to inform potential future implementation of the program. An effective, appropriately targeted, and well implemented exercise program for the long-term management (i.e., tertiary prevention) of LBP could minimize the burden of the condition on patients, the health care system and society. TRIAL REGISTRATION: ClinicalTrials.gov NCT05929846. This (Registration Date: July 3 2023) study has been approved by the Hamilton Integrated Research Ethics Board Project ID#15,354.

Alcohol withdrawal and amphetamine co-use in an animal model for attention deficit hyperactivity disorder.

Background: Non-medical use of amphetamine and other stimulants prescribed for treatment of attention deficit/hyperactivity disorder (ADHD) is of special concern when combined with alcohol consumption. In a previous study, we modeled chronic ethanol-amphetamine co-use in adolescent Long-Evans (LE) rats and provided evidence that amphetamine attenuates alcohol withdrawal symptoms.Objectives: This project modeled co-use of amphetamine with alcohol in adolescents with ADHD-like symptoms by examining ethanol-amphetamine administration in adolescent Spontaneously Hypertensive Rats (SHR), an experimental model for the study of ADHD. Withdrawal symptoms were compared among SHR and two control rat strains, LE and Wistar Kyoto (WKY).Methods: At postnatal day 32, parallel groups of 12-24 male SHR, WKY and LE rats were administered a liquid diet containing ethanol (3.6%) and/or amphetamine (20 mg/L). Following administration periods up to 26 days, rats were withdrawn from their treatment and tested for overall severity of alcohol withdrawal symptoms, general locomotor activity, and anxiety-like behavior.Results: Overall withdrawal severity was lower for SHR than for LE (p < .001) or WKY (p = .027). Co-consumption of amphetamine decreased withdrawal severity for LE (p = .033) and WKY (p = .011) but not SHR (p = .600). Only WKY showed increased anxiety-like behavior during withdrawal (p = .031), but not after amphetamine co-administration (p = .832).Conclusion: Alcohol withdrawal severity may be attenuated when co-used with amphetamine. However, as a model for ADHD, SHR adolescents appeared resistant to developing significant signs of alcohol withdrawal following alcohol consumption. Whether alcohol withdrawal symptoms are attenuated or absent, potential consequences could include a decreased awareness of an emerging problem with alcohol use.

Polymer Dots with Delayed Fluorescence and Tunable Cellular Uptake for Photodynamic Therapy and Time-Gated Imaging.

By combining bioimaging and photodynamic therapy (PDT), it is possible to treat cancer through a theranostic approach with targeted action for minimum invasiveness and side effects. Thermally activated delayed fluorescence (TADF) probes have gained recent interest in theranostics due to their ability to generate singlet oxygen (1O2) while providing delayed emission that can be used in time-gated imaging. However, it is still challenging to design systems that simultaneously show (1) high contrast for imaging, (2) low dark toxicity but high phototoxicity and (3) tunable biological uptake. Here, we circumvent shortcomings of TADF systems by designing block copolymers and their corresponding semiconducting polymer dots (Pdots) that encapsulate a TADF dye in the core and expose an additional boron-dipyrromethene (BODIPY) oxygen sensitizer in the corona. This architecture provides orange-red luminescent particles (ΦPL up to 18 %) that can efficiently promote PDT (1O2 QY=42 %) of HeLa cells with very low photosensitizer loading (IC50 ~0.05-0.13 µg/mL after 30 min). Additionally, we design Pdots with tunable cellular uptake but similar PDT efficiencies using either polyethylene glycol or guanidinium-based coronas. Finally, we demonstrate that these Pdots can be used for time-gated imaging to effectively filter out background fluorescence from biological samples and improve image contrast.

Chitosan Coating as a Strategy to Increase Postemergent Herbicidal Efficiency and Alter the Interaction of Nanoatrazine with Bidens pilosa Plants.

The atrazine nanodelivery system, composed of poly(ε-caprolactone) (PCL+ATZ) nanocapsules (NCs), has demonstrated efficient delivery of the active ingredient to target plants in previous studies, leading to greater herbicide effectiveness than conventional formulations. Established nanosystems can be enhanced or modified to generate new biological activity patterns. Therefore, this study aimed to evaluate the effect of chitosan coating of PCL+ATZ NCs on herbicidal activity and interaction mechanisms with Bidens pilosa plants. Chitosan-coated NCs (PCL/CS+ATZ) were synthesized and characterized for size, zeta potential, polydispersity, and encapsulation efficiency. Herbicidal efficiency was assessed in postemergence greenhouse trials, comparing the effects of PCL/CS+ATZ NCs (coated), PCL+ATZ NCs (uncoated), and conventional atrazine (ATZ) on photosystem II (PSII) activity and weed control. Using a hydroponic system, we evaluated the root absorption and shoot translocation of fluorescently labeled NCs. PCL/CS+ATZ presented a positive zeta potential (25 mV), a size of 200 nm, and an efficiency of atrazine encapsulation higher than 90%. The postemergent herbicidal activity assay showed an efficiency gain of PSII activity inhibition of up to 58% compared to ATZ and PCL+ATZ at 96 h postapplication. The evaluation of weed control 14 days after application ratified the positive effect of chitosan coating on herbicidal activity, as the application of PCL/CS+ATZ at 1000 g of a.i. ha-1 resulted in better control than ATZ at 2000 g of a.i. ha-1 and PCL+ATZ at 1000 g of a.i. ha-1. In the hydroponic experiment, chitosan-coated NCs labeled with a fluorescent probe accumulated in the root cortex, with a small quantity reaching the vascular cylinder and leaves up to 72 h after exposure. This behavior resulted in lower leaf atrazine levels and PSII inhibition than ATZ. In summary, chitosan coating of nanoatrazine improved the herbicidal activity against B. pilosa plants when applied to the leaves but negatively affected the root-to-shoot translocation of the herbicide. This study opens avenues for further investigations to improve and modify established nanosystems, paving the way for developing novel biological activity patterns.

Evaluation of methodological and reporting quality of systematic reviews on conservative non-pharmacological musculoskeletal pain management in children and adolescents: A methodological analysis.

BACKGROUND: There are no studies investigating the methodological and report quality of systematic reviews of non-pharmacological interventions for musculoskeletal pain management among children and adolescents. OBJECTIVE: To evaluate the methodological and reporting quality of systematic reviews on conservative non-pharmacological pain management in children and adolescents with musculoskeletal pain. METHODS: Searches were conducted on the Cochrane Database of Systematic Reviews, Medline, Embase, and three other databases. Two pairs of reviewers independently assessed each article according to the predetermined selection criteria. We assessed the methodological quality of systematic reviews, using the AMSTAR 2 checklist and the quality of reporting, using PRISMA checklist. Descriptive analysis was used to summarise the characteristics of all included systematic reviews. The percentage of systematic reviews achieving each item from the AMSTAR 2, PRISMA checklist and the overall confidence in the results were described. RESULTS: We included 17 systematic reviews of conservative non-pharmacological pain management for musculoskeletal pain in children and adolescents. Of the 17 systematic reviews included, nine (53%) were rated as "critically low", seven (41%) were rated as "low", and one (6%) was rated as "high" methodological quality by AMSTAR-2. The reporting quality by items from PRISMA range from 17.6% (95% CI 6.2 to 41) to 100% (95% CI 81.6 to 100). CONCLUSION: This systematic review of physical interventions in children and adolescents showed overall 'very low' to 'high' methodological quality and usually poor reporting quality.

Characterizing the Traveling Oncology Workforce and Its Influence on Patient Travel Burden: A Claims-Based Approach.

PURPOSE: Oncology outreach is a common strategy for extending cancer care to rural patients. However, a nationwide characterization of the traveling workforce that enables this outreach is lacking, and the extent to which outreach reduces travel burden for rural patients is unknown. METHODS: This cross-sectional study analyzed a rural (nonurban) subset of a 100% fee-for-service sample of 355,139 Medicare beneficiaries with incident breast, colorectal, and lung cancers. Surgical, medical, and radiation oncologists were linked to patients using Part B claims, and traveling oncologists were identified by observing hospital service area (HSA) transition patterns. We defined oncology outreach as the provision of cancer care by a traveling oncologist outside of their primary HSA. We used hierarchical gamma regression models to examine the separate associations between patient receipt of oncology outreach and one-way patient travel times to chemotherapy, radiotherapy, and surgery. RESULTS: On average, 9,935 of 39,960 oncologists conducted annual outreach, where 57.8% traveled with low frequency (0-1 outreach visits/mo), 21.1% with medium frequency (1-3 outreach visits/mo), and 21.1% with high frequency (>3 outreach visits/mo). Oncologists provided surgery, radiotherapy, and chemotherapy to 51,715, 27,120, and 5,874 rural beneficiaries, respectively, of whom 2.5%, 6.9%, and 3.6% received oncology outreach. Rural patients who received oncology outreach traveled 16% (95% CI, 11 to 21) and 11% (95% CI, 9 to 13) less minutes to chemotherapy and radiotherapy than those who did not receive oncology outreach, corresponding to expected one-way savings of 15.9 (95% CI, 15.5 to 16.4) and 11.9 (95% CI, 11.7 to 12.2) minutes, respectively. CONCLUSION: Our study introduces a novel claims-based approach for tracking the nationwide traveling oncology workforce and supports oncology outreach as an effective means for improving rural access to cancer care.

Neuromuscular and physiological responses to different training loads in Randori of elite judo athletes

Abstract Aim: To compare two different randori structure (high volume and short pauses - TRAD training vs low volume with long pauses - COMP training) in the neuromuscular and metabolic responses of elite judo athletes. Methods: The first situation (TRAD) consisted of 12 randoris of 5 minutes with 45 seconds rest, and the other situation (COMP), consisted of 6 randoris of 5 minutes with 10 minutes between them. Physiological (Blood Lactate and Creatine Kinase), neuromuscular (Countermovement Jump and Medicine Ball Throws) and perceptive variables (Rating Perceived Exertion) were measured before and at the end of the sessions. Results: The subjective perception of effort at the end of the training was significantly higher in the TRAD training type (TRADpost: 8.1 ± 0.9 AU; COMPpost: 6.6 ± 1.5 AU, p <0.001). Blood lactate concentration (TRADpost: 6.4 ± 2.2 mmol/L; COMPpost: 8.1 ± 2.9 mmol/L; p <0.001), CMJ height (TRADpost: 36.2 ± 4.6 cm; COMPpost: 35.9 ± 4.3 cm, p = 0.012) and upper limb power performance (TRADpost: 6.4 ± 0.9 m; COMPpost: 6.3 ± 0.9 m p = 0.03) were significantly higher at the end of the two training sessions compared to their start, but there are no group effect. There is group effect in CK (TRADpost: 490.7 ± 273.5 U/L; COMPpost: 357.4 ± 203.8 U/L; p <0.001). Conclusions: This study demonstrated that TRAD and COMP Judo training induced similar physical demands, and both seem to not be enough to reach higher intensities, which made them distant methods of competitive reality.

Potassium adsorption in soil cultivated with sugarcane

ABSTRACT Vinasse is a byproduct of the process of distillation of sugarcane juice for the manufacture of sugar and alcohol. Because it is rich in nutrients, mainly potassium (K), is used as fertilizer and applied via fertigation, without concerning for the fate of this compound in the soil. Thus, the objective of the study was to evaluate the interactions of the potassium ion (K+), applied via vinasse in a soil representative of the sugarcane zone of the State of Pernambuco using adsorption isotherms. The methodology was based on physical, chemical and soil mineralogical characterization, as well as equilibrium batch tests, where the experimental curves were fitted by Langmuir and Freundlich isotherm models. The results allowed to infer that the Freundlich model showed better fit of the curve in both forms: linear and non-linear (direct fit); the non-linear model was selected due to the values ​​of coefficient of determination (R²). The interaction between potassium and soil occurred mainly with organic matter and the presence of soil kaolinite, because they showed negative ions on the external surface, thereby promoting potassium adsorption. Soil potassium adsorption capacity was higher for the first layer (0-20 cm) and decreased along the depth profile.

Chondroblastic osteosarcoma of the mandible: case report / Osteossarcoma condroblástico em mandíbula: relato de caso

ABSTRACT We report the case of a 32-year-old male patient, who was subjected to cone-beam tomography for planning the removal of an unerupted tooth. Cone-beam CT scans revealed the presence of a mixed lesion with poorly defined limits in the left posterior mandibular region, with "sun-ray" periosteal reaction. An incisional biopsy was performed and the diagnosis was chondroblastic osteosarcoma. In this paper, a discussion of the differential diagnosis criteria and treatment of this unusual malignant neoplasm is performed. Thus, it is intended to provide information that will help in the study of management protocols for the increasingly effective treatment of gnathic osteosarcomas.

RESUMO Relatamos o caso de um paciente do sexo masculino, 32 anos de idade, que realizou tomografia cone-beam para planejamento de remoção de dente incluso. O exame revelou presença de lesão mista de limites mal definidos na região posterior mandibular esquerda, com reação periosteal em "raios de sol". Foi realizada biópsia incisional, e o diagnóstico foi de osteossarcoma condroblástico. Neste trabalho, será realizada uma discussão dos critérios de diagnóstico diferencial e do tratamento dessa neoplasia maligna. Pretende-se, dessa forma, trazer informações que auxiliem no estudo de protocolos de conduta para o tratamento cada vez mais efetivo dos osteossarcomas gnáticos.

Risk factors and injury prevention in elite athletes: a descriptive study of the opinions of physical therapists, doctors and trainers / Fatores de risco e prevenção de lesões em atletas de elite: estudo descritivo da opinião de fisioterapeutas, médicos e treinadores

Background: Musculoskeletal injuries occur frequently in elite athletes. Understanding what professionals who work with patients with sports injuries think about prevention has been suggested as an important aspect to improve the effectiveness of programs to prevent sports injuries. Objectives: To describe and characterize the opinions of physical therapists, physicians and trainers on 'risk factors' and 'prevention of injury' in elite athletes. Method: This is a qualitative study with semi-structured interviews with members of the medical and technical department of the Brazilian delegation who participated in the Pan American Games of Guadalajara 2011. The interview was conducted using two questions: 1) "What do you think can cause injuries in athletes participating in your sport?" 2) "What do you do to prevent injuries in your sport?" The interviews were analyzed in two stages, the identification of thematic units, followed by the categorization and grouping of thematic units. Results: We interviewed a total of 30 professionals. Regarding question 1, the main factors attributed as responsible for injury were over-training and incorrect sports techniques. Regarding question 2, the main reported strategies used to prevent injuries were muscle strengthening, nutritional counseling and guidance. Conclusions: The main factors affecting the appearance of lesions were over-training, incorrect sports technique, inadequate nutrition and factors related to the athlete's behavior. The main injury prevention strategies were muscle strengthening, nutritional counseling and guidance. .

Introdução: Lesões musculoesqueléticas ocorrem frequentemente na população de atletas de elite. Entender o que os profissionais que atuam com esporte de alto rendimento pensam sobre lesão e prevenção tem sido sugerido como um importante aspecto para se aumentar a eficácia de programas de prevenção de lesões no esporte. Objetivos: Descrever e caracterizar a opinião de fisioterapeutas, médicos e treinadores sobre fatores de risco e prevenção de lesões em atletas de elite. Método: Estudo qualitativo, realizado com entrevistas semiestruturadas numa parcela dos integrantes dos departamentos técnico e médico da delegação brasileira que participaram dos Jogos Pan-Americanos de Guadalajara 2011. A entrevista foi realizada a partir de duas perguntas: 1) O que você acha que pode causar lesões nos atletas da sua modalidade?, e 2) O que vocês fazem para a prevenção de lesões na sua modalidade?. As entrevistas foram analisadas em duas etapas, identificação das unidades temáticas, seguida da categorização e agrupamento de unidades temáticas. Resultados: Foram entrevistados um total de 30 profissionais. Em relação à pergunta 1, os principais fatores atribuídos como responsáveis pela lesão foram o excesso de treinamento e a técnica esportiva incorreta. Em relação à pergunta 2, as principais estratégias de prevenção de lesões utilizadas relatadas foram o fortalecimento muscular, o acompanhamento nutricional e orientações. Conclusões: Os principais fatores apontados para o surgimento de lesões foram excesso de treinamento, técnica esportiva incorreta, nutrição inadequada e fatores relacionados ao comportamento dos atletas. As principais estratégias de pr...

Description of research design of articles published in four Brazilian physical therapy journals

Background : While the research design of articles published in medical journals and in some physical therapy journals has already been evaluated, this has not been investigated in Brazilian physical therapy journals. Objective : To describe the research design used in all articles published in Brazilian scientific journals that are freely available, have high Qualis rankings, and are relevant to physical therapy over a 7-year period. Method : We extracted the bibliometric data, research design, research type (human or animal), and clinical area for all articles published. The articles were grouped into their level of evidence, and descriptive analyses were performed. We calculated the frequency, proportions of articles, and 95% confidence interval of these proportions with each research design in each journal. We cross-tabulated the clinical areas with research designs (expressed as number and percentages). Results : A total of 1,458 articles from four Brazilian journals were found: Revista Brasileira de Fisioterapia, Revista Fisioterapia em Movimento, Revista Fisioterapia e Pesquisa, and Revista Acta Fisiátrica. The majority of articles were classified as level II of evidence (60%), followed by level III (29%) and level I (10%). The most prevalent research designs were cross-sectional studies (38%), single-case or case-series studies, and narrative reviews. Most articles reported human research and were in the musculoskeletal, neurologic, and cardiothoracic areas. Conclusions : Most of the research published in Brazilian physical therapy journals used levels II and III of evidence. Increasing the publication rate of systematic reviews and randomized controlled trials would provide more high-quality evidence to guide evidence-based physical therapy practice. .

Hypothalamic-pituitary-gonadal function in men with liver cirrhosis before and after liver transplantation / Função do eixo hipotálamo-hipófise-gonadal em homens cirróticos antes e após o transplante hepático

Objective: To evaluate the influence of end-stage liver disease and orthotopic liver transplantation in the pituitary function and hormone metabolism before and after liver transplantation. Methods: In a prospective study, serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and prolactin (PRL) of 30 male patients with cirrhosis were determined two to four hours before and six months after liver transplantation. The results were compared according to the Model for End-stage Liver Disease (MELD). Results: male patients with liver cirrhosis have hypogonadism. FSH was normal, but inappropriately low due to androgen failure; E2 and PRL, on their turn, were high. After liver transplantation, FSH and LH levels increased (p < 0.05), whereas E2 and PRL normalized (p < 0.05). The MELD score did not influence changes in FSH, PRL and LH, however, the more severe the cirrhosis was, the more significant was the normalization of E2 (p = 0.01). Conclusion: Patients with cirrhosis and male hypogonadism have inappropriately normal levels of FSH and LH, associated with an increase in E2 and LRP. After liver transplantation, FSH and LH increased, while E2 and PRL returned to normal. Changes in E2 levels were most pronounced in patients with MELD > 18. The severity of cirrhosis had no influence on FSH, PRL and LH. .

Objetivo: avaliar a influência da doença hepática terminal e do transplante hepático ortotópico na função hipofisária e no metabolismo hormonal através da aferição dos níveis séricos dos hormônios folículo estimulante (FSH), hormônio luteinizante (HL), estradiol (E2) e prolactina (PRL) antes e após o transplante hepático. Métodos: em um estudo prospectivo, níveis séricos dos hormônios folículo estimulante (FSH), hormônio luteinizante (HL), estradiol (E2) e prolactina (PRL) de 30 paciente masculinos com cirrose foram determinados duas a quatro horas antes e seis meses após o transplante hepático. Os resultados foram comparados de acordo com o Model for End-stage Liver Disease (MELD). Resultados: acientes masculinos com cirrose hepática apresentam hipogonadismo. O FSH encontravam-se normais, porém inapropriadamente baixos devido à falência androgênica; já o E2 e o PRL estavam elevados. Após o transplante hepático, os níveis de FHS e HL aumentaram (p < 0,05), enquanto o E2 e o PRL normalizaram (p < 0,05). O MELD não influenciou as alterações no FSH, HL ou PRL, todavia, quanto mais grave a cirrose, mais significante foi a normalização do E2 (p=0,01). Conclusão: pacientes masculinos com cirrose e hipogonadismo apresentam níveis inapropriadamente normais de FSH e HL, associados com elevação do E2 e PRL. Após o transplante hepático, FSH e HL aumentaram, enquanto E2 e PRL retornaram aos valores normais. As alterações nos níveis de E2 foram mais pronunciadas em pacientes com MELD > 18. A gravidade da cirrose não teve influência no FSH, HL e PRL. .

Influence of saccharose on the development of cercariae from Schistosoma mansoni strains BH and SJ

Foi estudado o desenvolvimento de cercárias de Schistosoma mansoni das linhagens BH e SJ em Biomphalaria glabrata e Biomphalaria tenagophila, respectivamente, tratadas com sacarose. Os moluscos foram mantidos em água declorada contendo 0,01% de sacarose. Após uma semana de tratamento com sacarose, B. glabrata e B. tenagophila foram expostas a dez miracídios de S. mansoni das linhagens BH e SJ, respectivamente. Moluscos controles de ambas as espécies mantidos em água declorada sem sacarose foram expostos ao mesmo número de miracídios. Não houve diferença significativa entre as taxas de infecção dos moluscos tratados ou não com sacarose. Entretanto, os dois grupos de B. glabrata tiveram taxas de infecção significativamente maiores que as correspondentes aos grupos de B. tenagophila. Moluscos tratados com sacarose apresentaram menor taxa de sobrevivência, com a maior mortalidade ocorrendo imediatamente depois e no início da liberação de cercárias. O tratamento com sacarose não resultou na maior liberação de cercárias, mas larvas de moluscos tratados com esse açúcar mostraram maior capacidade de penetrar na pele de camundongo, o que foi atribuído ao maior suprimento de energia durante o desenvolvimento larval no molusco.