Neurological consequences of exercise during prenatal Zika virus exposure to mice pups.

PURPOSE/AIM: Zika virus (ZIKV) infection during the pregnancy period is related to microcephaly and neurobehavioral disorders at birth, while prenatal exercise is supposed to provide neuroprotection in newborns pups. The aim of this study was to investigate the neurological consequences of exercise during prenatal ZIKV exposure to mice pups. MATERIAL AND METHODS: Twelve weeks female mice were randomly assigned into three groups: Control group, intraperitoneally injected with saline (Control); untrained group, intraperitoneally injected with ZIKV (ZIKV); and trained group, intraperitoneally injected with ZIKV (ZIKV/swim). There was one familiarization week prior to the beginning of the swimming training. Dams swam for 60 min/session, 5 days/week, during 4 weeks. Mating occurred between the fifth and seventh day of the first week of the swimming training. ZIKV 106 plaque-forming units/100 µl (106 PFUs/100 µl) or an equal volume of saline was intraperitoneally injected in the pregnant mice at embryonic day 10.5. Pup's body mass and brain weight were measured at postnatal day 1 (P1). Behavioral tests were performed from P30 to P35. Thereafter, hippocampal levels of syntaxin-1, GFAP, IBA-1, and BDNF were measured. RESULTS: Exercise during prenatal ZIKV exposure prevented brain atrophy, development of depression, anxiety, and disruption of social behavior. Exercise during prenatal ZIKV exposure inhibited the overexpression of microglia (IBA-1) and astrocytes (GFAP), with reduction of BDNF levels in the hippocampi of female and male mice pups. No significant changes were seen in syntaxin-1 levels. CONCLUSION: Our findings reveal beneficial effects of exercise during pregnancy exposure to ZIKV in mice pups.

Automated Computational Detection of Disease Activity in ANCA-Associated Glomerulonephritis Using Raman Spectroscopy: A Pilot Study.

Biospectroscopy offers the ability to simultaneously identify key biochemical changes in tissue associated with a given pathological state to facilitate biomarker extraction and automated detection of key lesions. Herein, we evaluated the application of machine learning in conjunction with Raman spectroscopy as an innovative low-cost technique for the automated computational detection of disease activity in anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis (AAGN). Consecutive patients with active AAGN and those in disease remission were recruited from a single UK centre. In those with active disease, renal biopsy samples were collected together with a paired urine sample. Urine samples were collected immediately prior to biopsy. Amongst those in remission at the time of recruitment, archived renal tissue samples representative of biopsies taken during an active disease period were obtained. In total, twenty-eight tissue samples were included in the analysis. Following supervised classification according to recorded histological data, spectral data from unstained tissue samples were able to discriminate disease activity with a high degree of accuracy on blind predictive modelling: F-score 95% for >25% interstitial fibrosis and tubular atrophy (sensitivity 100%, specificity 90%, area under ROC 0.98), 100% for necrotising glomerular lesions (sensitivity 100%, specificity 100%, area under ROC 1) and 100% for interstitial infiltrate (sensitivity 100%, specificity 100%, area under ROC 0.97). Corresponding spectrochemical changes in paired urine samples were limited. Future larger study is required, inclusive of assigned variables according to novel non-invasive biomarkers as well as the application of forward feature extraction algorithms to predict clinical outcomes based on spectral features.

Smile attractiveness in class III patients after orthodontic camouflage or orthognathic surgery.

OBJECTIVE: The study's objective was to compare the smile attractiveness in patients with class III malocclusion treated with orthodontic camouflage or orthognathic surgery. MATERIAL AND METHODS: The sample consisted of 30 patients with class III malocclusion treated without extractions divided into two groups, according to the treatment performed: G1, orthodontic camouflage, consisting of 15 patients (9 female; 6 male) with mean initial age of 21.26 years (SD = 7.39) and mean final age of 24.52 years (SD = 7.10). The mean treatment time was 3.26 years (SD = 1.50). G2, ortho-surgical, consisting of 15 patients (8 females; 7 males), with mean initial age of 23.12 years (SD=7.37), mean final age of 25.82 years (SD = 7.14) and mean treatment time of 2.71 years (SD = 0.90). The smile attractiveness was evaluated in black and white photographs of posed smiles taken before and after treatment, with a numerical rating scale from 1 to 10, with 1 being the least attractive and 10 the greatest smile attractiveness. The smiles were evaluated in a questionnaire by 111 participants, 67 orthodontists (mean age 41.31 years, SD = 9.44) and 44 laypeople (mean age 41.41 years, SD = 14.38). Intergroup comparison was performed with independent t test. RESULTS: There was a significant improvement in the smile attractiveness with both camouflage and ortho-surgical treatments. The smile attractiveness was similar between the camouflage and surgical groups at the beginning. There was a significantly greater improvement in smile attractiveness with treatment in the surgical group than in the camouflage group, and at the end of treatment, the surgical group showed greater smile attractiveness than the camouflage group. Orthodontists considered the smiles more attractive both at the beginning and the end of treatment when compared to the assessment made by laypeople. CONCLUSION: The ortho-surgical treatment promoted a greater improvement in the smile attractiveness, and at the final stage, a greater smile attractiveness than the orthodontic camouflage. CLINICAL RELEVANCE: Smile attractiveness is an important characteristic of the final result of orthodontic treatment. Knowing which treatment protocol will provide a better improvement and outcome regarding smile esthetics is essential.

Inductively coupled plasma mass spectrometry based platforms for studies involving nanoparticle effects in biological samples.

The widespread application of nanoparticles (NPs) in recent times has caused concern because of their effects in biological systems. Although NPs can be produced naturally, industrially synthesized NPs affect the metabolism of a given organism because of their high reactivity. The biotransformation of NPs involves different processes, including aggregation/agglomeration, and reactions with biomolecules that will be reflected in their toxicity. Several analytical techniques, including inductively coupled plasma mass spectrometry (ICP-MS), have been used for characterizing and quantifying NPs in biological samples. In fact, in addition to providing information regarding the morphology and concentration of NPs, ICP-MS-based platforms, such as liquid chromatography/ICP-MS, single-particle ICP-MS, field-flow fractionation (asymmetrical flow field-flow fractionation)-ICP-MS, and laser ablation-ICP-MS, yield elemental information about molecules. Furthermore, such information together with speciation analysis enlarges our understanding of the interaction between NPs and biological organisms. This study reports the contribution of ICP-MS-based platforms as a tool for evaluating NPs in distinct biological samples by providing an additional understanding of the behavior of NPs and their toxicity in these organisms.

An update on potential links between type 2 diabetes mellitus and Alzheimer's disease.

Alzheimer's disease (AD) and type 2 diabetes (T2D) major feature is insulin resistance. Brain and peripheral insulin resistance lead to hyperglycemia, which contributes to the development of T2D-linked comorbidities, such as obesity and dyslipidemia. Individuals with hyperglycemia in AD present with neuronal loss, formation of plaques and tangles and reduced neurogenesis. Inflammation seems to play an essential role in the development of insulin resistance in AD and T2D. We conducted a literature review about the links between AD and T2D. Alterations in glucose metabolism result from changes in the expression of the insulin receptor substrates 1 and 2 (IRS-1 and IRS-2), and seem to be mediated by several inflammatory pathways being present in both pathologies. Although there are some similarities in the insulin resistance of AD and T2D, brain and peripheral insulin resistance also have their discrete features. Failure to activate IRS-1 is the hallmark of AD, while inhibition of IRS-2 is the main feature in T2D. Inflammation mediates the alterations in glucose metabolism in AD and T2D. Targeting inflammation and insulin receptors may be a successful strategy to prevent and ameliorate T2D and AD symptoms.

Use of indocyanine green to minimise uretero-enteric strictures after robotic radical cystectomy.

OBJECTIVE: To evaluate the impact of indocyanine green (ICG) for assessing ureteric vascularity on the rate of uretero-enteric stricture formation after robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD). PATIENTS AND METHODS: We identified 179 patients undergoing RARC and ICUD between January 2014 and May 2017, and divided the patients into two groups based on the utilisation of ICG for the assessment of ureteric vascularity (non-ICG group and ICG group). We retrospectively reviewed the medical records to identify the length of ureter excised. Demographic, perioperative outcomes (including 90-day complications and readmissions), and the rate of uretero-enteric stricture were compared between the two groups. The two groups were compared using the t-test for continuous variables and the chi-squared test for categorical variables. A P < 0.05 was considered statistically significant. RESULTS: A total of 132 and 47 patients were in the non-ICG group and the ICG group, respectively. There were no differences in baseline characteristics and perioperative outcomes including operating time, estimated blood loss, and length of stay. The ICG group was associated with a greater length of ureter being excised during the uretero-enteric anastomosis and a greater proportion of patients having long segment (>5 cm) ureteric resection. The median follow-up was 14 and 12 months in the non-ICG and ICG groups, respectively. The ICG group was associated with no uretero-enteric strictures compared to a per-patient stricture rate of 10.6% and a per-ureter stricture rate of 6.6% in the non-ICG group (P = 0.020 and P = 0.013, respectively). CONCLUSION: The use of ICG fluorescence to assess distal ureteric vascularity during RARC and ICUD may reduce the risk of ischaemic uretero-enteric strictures. The technique is simple, safe, and reproducible. Larger studies with longer follow-up are needed to confirm our findings.

Effect of Cold Water Immersion Performed on Successive Days on Physical Performance, Muscle Damage, and Inflammatory, Hormonal, and Oxidative Stress Markers in Volleyball Players.

de Freitas, VH, Ramos, SP, Bara-Filho, MG, Freitas, DGS, Coimbra, DR, Cecchini, R, Guarnier, FA, and Nakamura, FY. Effect of cold water immersion performed on successive days on physical performance, muscle damage, and inflammatory, hormonal, and oxidative stress markers in volleyball players. J Strength Cond Res 33(2): 502-513, 2019-The aim of this study was to investigate the effects of daily cold water immersion (CWI) on physical performance, muscle damage, and inflammatory, hormonal, and oxidative stress markers in volleyball. Six players were submitted to CWI and six players to a placebo, during 5 training days. Thigh circumference, squat jump, and agility were measured on the first, third, and sixth days. On the first and sixth days, blood and saliva were collected for analysis of oxidative stress, muscle damage, and inflammatory and hormonal levels. Muscle soreness and countermovement jump were quantified daily. The physical performance comparisons did not present differences and the only between group comparison with a large effect size (ES = -1.39) was in Δ% between day 1 and day 2 for countermovement jump. Delayed onset muscle soreness and creatine kinase increased in both groups and the ESs of between group comparisons of Δ% between moments were not more than moderate. Thigh circumference increased only in the placebo group (p = 0.04) and the ES of the between group comparisons of Δ% between moments was large (1.53). No differences were found in oxidative stress, or inflammatory markers. Cortisol decreased only in the CWI-group (p ≤ 0.05) and the ESs of the between group comparisons of Δ% between moments of the testosterone to cortisol ratio (-1.94) and insulin-like growth-1 (-1.34) were large. Despite the positive effects of daily CWI on muscle edema and hormonal status, the limited effects of CWI on performance, muscle damage, inflammation markers, and reactive oxygen species mediators signal the unimportance of the daily practice of this recovery method in volleyball players.

Strategy to improve malaria surveillance system preventing transfusion-transmitted malaria in blood banks using molecular diagnostic.

BACKGROUND: Malaria can be transmitted by blood transfusion through donations collected from asymptomatic or parasitic donors. The parasites are released into the bloodstream during its life cycle and will therefore be present in donated blood by infected individuals. All cases of transfusion-transmitted malaria (TTM) notified since 2005 in Brazil were fatal. A good screening tool for Plasmodium spp. detection in blood units must have a high detection threshold, and the prevention of TTM relies entirely on the exclusion of potentially infected donors. However, in Brazilian blood banks, the screening test relies on blood thick smears examination. METHODS: The molecular diagnostic based on mitochondrial DNA (mtDNA) using real time PCR (mt-qPCR) was improved to detect Plasmodium falciparum, Plasmodium vivax, and standardized for use in Plasmodium malariae. The analytic sensitivity of this mt-qPCR methodology was performed using a sample of P. vivax. RESULTS: The mt-qPCR was highly efficient, and the analytic sensitivity for P. vivax was determined (0.000006 parasites/µL). This method was tested to detect P. vivax and P. falciparum in individuals from two malaria-endemic areas in Brazil, Amazon region (Pará and Rondônia states), the samples were collected in 10 reference units of two blood banks (Pará/nine cities and Rondônia/Porto Velho), and parasites mtDNA were detected in 10 of 2224 potential blood donors (0.45%). In all 10 positive samples, only P. vivax was detected. CONCLUSION: Molecular diagnostic using mt-qPCR was effective in revealing infected potential donors with good perspectives to be applied as screening routine of asymptomatic carriers for preventing transfusion-transmitted malaria in blood banks.

Blood-based near-infrared spectroscopy for the rapid low-cost detection of Alzheimer's disease.

Alzheimer's disease (AD) is currently under-diagnosed and is predicted to affect a great number of people in the future, due to the unrestrained aging of the population. An accurate diagnosis of AD at an early stage, prior to (severe) symptomatology, is of crucial importance as it would allow the subscription of effective palliative care and/or enrolment into specific clinical trials. Today, new analytical methods and research initiatives are being developed for the on-time diagnosis of this devastating disorder. During the last decade, spectroscopic techniques have shown great promise in the robust diagnosis of various pathologies, including neurodegenerative diseases and dementia. In the current study, blood plasma samples were analysed with near-infrared (NIR) spectroscopy as a minimally-invasive method to distinguish patients with AD (n = 111) from non-demented volunteers (n = 173). After applying multivariate classification models (principal component analysis with quadratic discriminant analysis - PCA-QDA), AD individuals were correctly identified with 92.8% accuracy, 87.5% sensitivity and 96.1% specificity. Our results show the potential of NIR spectroscopy as a simple and cost-effective diagnostic tool for AD. Robust and early diagnosis may be a first step towards tackling this disease by allowing timely intervention.

Disaster preparation in kidney transplant recipients: a questionnaire-based cohort study from a large United States transplant center
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BACKGROUND: Few quantitative assessments have assessed disaster preparation in kidney transplant patients. This is a survey-based assessment of disaster preparedness of 200 patients at the University of California San Francisco, USA. MATERIALS AND METHODS: Patients answered questionnaires assessing their level of preparedness as well as barriers to preparation. Preparedness was scored based on response to 7 questions. Univariate analyses compared participant characteristics extracted from the medical chart against three tertiles of preparedness: low (scores 0 - 2), medium (scores 3 - 4), and high (scores 5 - 7). California counties were coded and mapped by average preparedness scores. RESULTS: Only 30% of patients were highly prepared for disasters. Participants were prepared with available medication for 2 weeks (78.5%) and least prepared in having a medical ID bracelet (13%). Significant minorities of patients (40% of patients or more) were unprepared with lists of medications, important phone numbers and disaster kits. Preparedness was not associated with demographic and clinical characteristics. Monterey County was the most prepared of the 31 California counties sampled (score of 4.25 out of 7). CONCLUSION: All patients should be educated regarding disaster preparation. County and medical services should collaborate to address specialized populations in general preparedness planning.
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[Primary health care for South-American indigenous peoples: an integrative review of the literatureAtención primaria en salud a indígenas de América del Sur: revisión integrativa de la bibliografía]. / Atenção primária à saúde de indígenas sul-americanos: revisão integrativa da literatura.

OBJECTIVE: To review the literature regarding the access to primary health care (PHC) by indigenous communities in South America, identifying the main access barriers. METHOD: Integrative review of articles published from 2007 to 2017 in the LILACS, PubMed, and SciELO databases. The search terms "indigenous AND health AND Brazil" and "indigenous AND health NOT Brazil" were used in Portuguese and English. Articles published in English, Portuguese, or Spanish, focusing strictly on PHC and on South-American indigenous populations were included. RESULTS: Forty articles describing aspects of PHC for indigenous populations in eight countries - Brazil, Peru, Colombia, Bolivia, Argentina, Chile, Paraguay, and Ecuador - were included. The main barriers to accessing PHC were the difficulty of reaching the health care facilities closest to villages; difficulty in communicating with health care professionals; inadequate transportation to the health care units; lack of epidemiological data on indigenous villages; lack of information regarding local indigenous cultures; and fear of discrimination or humiliation on the part of indigenous patients. CONCLUSIONS: Studies regarding the health of indigenous populations in South America are scarce. It is evident that national health systems still need to advance towards an intercultural medicine that respects the social, cultural, and economic realities of all communities, with knowledge and consideration for different forms of care.

OBJETIVO: Revisar la bibliografía acerca del acceso a la atención primaria de salud (APS) de las comunidades indígenas de América del Sur, e identificar los principales obstáculos a ese acceso. MÉTODOS: Revisión integrativa de artículos publicados desde 2007 a 2017 en las bases de datos LILACS, PubMed y SciELO. Para la búsqueda se utilizaron los siguientes descriptores: "indígenas AND salud AND Brasil" e "indígenas AND salud NOT Brasil" en portugués e inglés. Se incluyeron artículos publicados en inglés, portugués y español que abordaran estrictamente la APS en indígenas de América del Sur. RESULTADOS: Se incluyeron 40 artículos que describieron los aspectos de la APS en indígenas de ocho países: Argentina, Bolivia, Chile, Colombia, Brasil, Ecuador, Paraguay y Perú. Los principales obstáculos de acceso a la APS detectados fueron la dificultad de acceso a los servicios de salud más próximos de las aldeas; lenguaje e ilustraciones de las cartillas de educación en salud inapropiadas al contexto indígena; dificultad de comunicación con los profesionales de salud; carencia de medios de transporte adecuados hasta las unidades de salud; escasez de datos epidemiológicos de las aldeas indígenas; ausencia de información sobre las culturas indígenas locales; y miedo de discriminación o humillación en el paciente indígena. CONCLUSIONES: Aún son escasos los estudios sobre la salud indígena en América del Sur. Es evidente que los sistemas de salud nacionales aún necesitan avanzar hacia una medicina intercultural, con respeto a las realidades sociales, culturales y económicas de todas las comunidades asistidas, con conocimiento y consideración de las diferentes formas de cuidados.

A mixed-methods investigation of incident Hemodialysis access in a safety-net population.

BACKGROUND: Despite improved health outcomes associated with arteriovenous fistulas, 80% of Americans initiate hemodialysis using a catheter, influenced by low socioeconomic status among other factors. Risk factors for incident catheter use in safety-net populations are unknown. Our objective was to identify factors associated with incident catheter use among hemodialysis patients at one safety-net hospital, with a goal of informing fistula placement initiatives targeted at safety-net populations more generally. METHODS: We performed a retrospective review of all incident hemodialysis patients at a single urban safety-net hospital from January 1, 2010 - December 31, 2015 (n = 241), as well as semi-structured interviews with a multi-lingual convenience sample of patients (n = 10) from this cohort. The primary outcome was incident vascular access modality. Multivariable logistic regression was used to identify factors associated with incident catheter use. Interview transcripts were coded using a directed content analysis framework based on a model describing barriers to healthcare access. RESULTS: Subjects were 61.8% male, racially/ethnically diverse (19.5% white, 29.5% black, 28.6% Hispanic, 17.4% Asian), with a mean age of 52.4 years. Eighty-eight percent initiated hemodialysis using a catheter. In multivariable analysis, longer duration of nephrology care was associated with decreased catheter use (>12 months vs. 0-6 months: adjusted Odds Ratio [aOR] 0.07, 95% CI 0.02-0.23, p < 0.001), whereas uninsured status increased odds of catheter use (aOR 3.96, 1.23-12.76, p = 0.02). There was a decrease in catheter use after vascular surgery services became available in-hospital (OR 0.40, 95% CI 0.16-0.98, p = 0.04), however this association was not significant in multivariable analysis (aOR 0.48, 0.17-1.36, p = 0.17). During interviews, patients cited emotional responses to disease, lack of social and financial resources, and limited health knowledge as barriers to obtaining fistula surgery. CONCLUSIONS: The rate of catheter use in this urban safety-net population is above the national average. Access to health insurance, early referrals to nephrology, and provision of in-hospital vascular surgery should be prioritized in the safety-net. Additionally, services that support patients' emotional and learning needs may decrease delays in fistula placement.

Relapse of anterior crowding 3 and 33 years postretention.

INTRODUCTION: The aim of this study was to evaluate the relapse of occlusal characteristics and maxillary and mandibular anterior crowding 3 and 33 years postretention. METHODS: The sample comprised 28 patients, 15 Class I and 13 Class II, treated with 4 premolar extractions, with a mean initial age of 12.72 years (SD, 0.99), a mean final age of 14.74 years (SD, 1.26), and a mean treatment time of 2.02 years (SD, 0.66). The mean short-term postretention age was 20.15 years (SD, 1.34), and the mean long-term postretention age was 49.40 years (SD, 4.54). The mean time of short-term postretention evaluation was 3.70 years (SD, 0.87) and the mean long-term postretention evaluation was 32.95 years (SD, 4.31). The maxillary and mandibular irregularity indexes were assessed on the initial, final, short-term, and long-term postretention stage dental casts. Peer Assessment Rating and the Little indexes were compared among the 4 stages by repeated measures analysis of variance and Tukey tests. RESULTS: Peer Assessment Rating index and maxillary anterior crowding were significantly improved with treatment, had significant relapses in the short term, and a slight and not statistically significant increase from short-term to long-term postretention evaluation. The mandibular irregularity index significantly decreased with treatment, and then significantly and progressively increased in the postretention stages. CONCLUSIONS: The occlusal characteristics and maxillary anterior crowding had significant relapses in the short term and remained stable from the short-term to the long-term postretention stages. Mandibular anterior crowding significantly decreased with treatment, showed a significant relapse in the short term, and continued to significantly increase in the long-term postretention stage.

Berberine Antifungal Activity in Fluconazole-Resistant Pathogenic Yeasts: Action Mechanism Evaluated by Flow Cytometry and Biofilm Growth Inhibition in Candida spp.

The incidence of fungal infections and, in particular, the incidence of fungal antibiotic resistance, which is associated with biofilm formation, have significantly increased, contributing to morbidity and mortality. Thus, new therapeutic strategies need to be developed. In this context, natural products have emerged as a major source of possible antifungal agents. Berberine is a protoberberine-type isoquinoline alkaloid isolated from the roots, rhizomes, and stem bark of natural herbs, such as Berberis aquifolium, Berberis vulgaris, Berberis aristata, and Hydrastis canadensis, and of Phellodendron amurense Berberine has been proven to have broad antibacterial and antifungal activity. In the present study, the potential antifungal effect of berberine against fluconazole-resistant Candida and Cryptococcus neoformans strains, as well as against the biofilm form of Candida spp., was assessed. The antifungal effect of berberine was determined by a broth microdilution method (the M27-A3 method of the Clinical and Laboratory Standards Institute) and flow cytometry techniques, in which the probable mechanism of action of the compound was also assessed. For biofilm assessment, a colorimetric 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay was used to determine the susceptibility of sessile cells. The isolates used in the study belonged to the Laboratory of Bioprospection and Experiments in Yeast (LABEL) of the Federal University of Ceará. After 24 and 72 h, fluconazole-resistant Candida and Cryptococcus neoformans strains showed berberine MICs equal to 8 µg/ml and 16 µg/ml, respectively. Cytometric analysis showed that treatment with berberine caused alterations to the integrity of the plasma and mitochondrial membranes and DNA damage, which led to cell death, probably by apoptosis. Assessment of biofilm-forming isolates after treatment showed statistically significant reductions in biofilm cell activity (P < 0.001).

Beyond the passive interactions at the nano-bio interface: evidence of Cu metalloprotein-driven oxidative dissolution of silver nanoparticles.

BACKGROUND: In a biological system, an engineered nanomaterial (ENM) surface is altered by adsorbed proteins that modify ENM fate and toxicity. Thus far, protein corona characterizations have focused on protein adsorption, interaction strength, and downstream impacts on cell interactions. Given previous reports of Ag ENM disruption of Cu trafficking, this study focuses on Ag ENM interactions with a model Cu metalloprotein, Cu(II) azurin. The study provides evidence of otherwise overlooked ENM-protein chemical reactivity within the corona: redox activity. RESULTS: Citrate-coated Ag ENMs of various sizes (10-40 nm) reacted with Cu(II) azurin resulted in an order of magnitude more dissolved ionic silver (Ag(I)(aq)) than samples of Ag ENMs only, ENMs mixed Cu(II) ions, or control proteins such as cytochrome c and horse radish peroxidase. This dramatic increase in ENM oxidative dissolution was observed even when Cu(II) azurin was combined with a diverse mixture of Escherchia coli proteins to mimic the complexity of the cellular conona. SDS PAGE results confirm that the multiprotein ENM corona includes azurin. A Cu(I)(aq) colorimetric indicator confirms Cu(II) azurin reduction upon interaction with Ag ENMs, but not with the addition of ionic silver, Ag(I)(aq). CONCLUSIONS: Cu(II) azurin and 10-40 nm Ag ENMs react to catalyze Ag ENM oxidative dissolution and reduction of the model Cu metalloprotein. Results push the current evaluation of protein-ENM characterization beyond passive binding interactions and enable the proposal of a mechanism for reactivity between a model Cu metalloprotein and Ag ENMs.

The Regulatory Pathway for Advanced Cell Therapy and Gene Therapy Products in Brazil: A Road to Be Built.

The regulation of cell therapy and gene therapy products is a major challenge for the Brazilian state. From a legal point of view, the legislative apparatus, including constitutional, prohibits the marketing and patent of human substances. From the point of view of the organization of the state bureaucracy, the responsibilities for the regulation of research and application of these technologies in humans may involve up to four different institutions. The National Agency for Health Surveillance (ANVISA) has been the protagonist in structuring the regulation of cell therapy and gene therapy in Brazil, and steps have been taken to ensure quality of these products. However, obstacles such as the commercialization of these therapies and the need to determine whether these products will be regulated following the assumptions adopted in Brazil for drugs and biological products or for human blood and tissues still remain.

Intramucosal nevus in the oral cavity.

AIM: The aim of this study is to report a clinical case of oral nevus. BACKGROUND: Nevus is a congenital or acquired benign neoplasia that can be observed in the skin or mucous membranes. It is an uncommon condition in the oral mucosa. When it does occur, the preferred location is on the palate, followed by the cheek mucosa, lip and tongue. CASE REPORT: In this case study, we relate the diagnosis and treatment of a 23-year-old female patient with an irregular, pigmented lesion of the oral mucosa that underwent excisional biopsy resulting in a diagnosis of intramucosal nevus. CONCLUSION: Nevus can appear in the oral mucosa and should be removed. CLINICAL SIGNIFICANCE: It is important for dental professionals to adequately categorize and treat pigmented lesions in the mouth.

[Depression and suicide risk among nursing professionals: an integrative review]. / Depressão e risco de suicídio entre profissionais de Enfermagem: revisão integrative.

OBJECTIVE: Discussing the factors associated with major depression and suicide risk among nursing professionals. METHOD: An integrative review in PubMed/MEDLINE, LILACS, SciELO and BDENF databases, between 2003 and 2015. RESULTS: 20 published articles were selected, mostly from between 2012 and 2014, with significant production in Brazil. Nursing professionals are vulnerable to depression when young, married, performing night work and having several jobs, and when they have a high level of education, low family income, work overload, high stress, insufficient autonomy and a sense of professional insecurity and conflict in the family and workrelationship. Suicide risk was correlated with the presence of symptoms of depression, high levels of emotional exhaustion, depersonalization and low personal accomplishment; characteristics of Burnout Syndrome. CONCLUSION: Suicide risk among nursing professionals is associated with symptoms of depression and correlated with Burnout Syndrome, which can affect work performance.

Detecting glaucoma using automated pupillography.

OBJECTIVE: To evaluate the ability of a binocular automated pupillograph to discriminate healthy subjects from those with glaucoma. DESIGN: Cross-sectional observational study. PARTICIPANTS: Both eyes of 116 subjects, including 66 patients with glaucoma in at least 1 eye and 50 healthy subjects from the Diagnostic Innovations in Glaucoma Study. Eyes were classified as glaucomatous by repeatable abnormal standard automated perimetry (SAP) or progressive glaucomatous changes on stereophotographs. METHODS: All subjects underwent automated pupillography using the RAPDx pupillograph (Konan Medical USA, Inc., Irvine, CA). MAIN OUTCOME MEASURES: Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic ability of pupil response parameters to white, red, green, yellow, and blue full-field and regional stimuli. A ROC regression model was used to investigate the influence of disease severity and asymmetry on diagnostic ability. RESULTS: The largest area under the ROC curve (AUC) for any single parameter was 0.75. Disease asymmetry (P <0.001), but not disease severity (P = 0.058), had a significant effect on diagnostic ability. At the sample mean age (60.9 years), AUCs for arbitrary values of intereye difference in SAP mean deviation (MD) of 0, 5, 10, and 15 dB were 0.58, 0.71, 0.82, and 0.90, respectively. The mean intereye difference in MD was 2.2±3.1 dB. The best combination of parameters had an AUC of 0.85; however, the cross-validated bias-corrected AUC for these parameters was only 0.74. CONCLUSIONS: Although the pupillograph had a good ability to detect glaucoma in the presence of asymmetric disease, it performed poorly in those with symmetric disease.

Use of statistical analyses in the ophthalmic literature.

PURPOSE: To identify the most commonly used statistical analyses in the ophthalmic literature and to determine the likely gain in comprehension of the literature that readers could expect if they were to add knowledge of more advanced techniques sequentially to their statistical repertoire. DESIGN: Cross-sectional study. METHODS: All articles published from January 2012 through December 2012 in Ophthalmology, the American Journal of Ophthalmology, and Archives of Ophthalmology were reviewed. A total of 780 peer-reviewed articles were included. Two reviewers examined each article and assigned categories to each one depending on the type of statistical analyses used. Discrepancies between reviewers were resolved by consensus. MAIN OUTCOME MEASURES: Total number and percentage of articles containing each category of statistical analysis were obtained. Additionally, we estimated the accumulated number and percentage of articles that a reader would be expected to be able to interpret depending on their statistical repertoire. RESULTS: Readers with little or no statistical knowledge would be expected to be able to interpret the statistical methods presented in only 20.8% of articles. To understand more than half (51.4%) of the articles published, readers would be expected to be familiar with at least 15 different statistical methods. Knowledge of 21 categories of statistical methods was necessary to comprehend 70.9% of articles, whereas knowledge of more than 29 categories was necessary to comprehend more than 90% of articles. Articles related to retina and glaucoma subspecialties showed a tendency for using more complex analysis when compared with articles from the cornea subspecialty. CONCLUSIONS: Readers of clinical journals in ophthalmology need to have substantial knowledge of statistical methodology to understand the results of studies published in the literature. The frequency of the use of complex statistical analyses also indicates that those involved in the editorial peer-review process must have sound statistical knowledge to appraise critically the articles submitted for publication. The results of this study could provide guidance to direct the statistical learning of clinical ophthalmologists, researchers, and educators involved in the design of courses for residents and medical students.