Mpox outbreak in Rio de Janeiro, Brazil: A translational approach.

Mpox is a zoonotic disease historically reported in Africa. Since 2003, limited outbreaks have occurred outside Africa. In 2022, the global spread of cases with sustained interhuman transmission and unusual disease features raised public health concerns. We explore the mpox outbreak in Rio de Janeiro (RJ) state, Brazil, in an observational study of mpox-suspected cases from June to December 2022. Data collection relied on a public healthcare notification form. Diagnosis was determined by MPXV-PCR. In 46 confirmed cases, anti-OPXV IgG was determined by ELISA, and seven MPXV genomes were sequenced. A total of 3095 cases were included, 816 (26.3%) with positive MPXV-PCR results. Most positive cases were men in their 30 s and MSM. A total of 285 (34.9%) MPXV-PCR+ patients live with HIV. Eight were coinfected with varicella-zoster virus. Anogenital lesions and adenomegaly were associated with the diagnosis of mpox. Females and individuals under 18 represented 9.4% and 5.4% of all confirmed cases, respectively, showing higher PCR cycle threshold (Ct) values and fewer anogenital lesions compared to adult men. Anti-OPXV IgG was detected in 29/46 (63.0%) patients. All analyzed sequences belonged to clade IIb. In RJ state, mpox presented a diverse clinical picture, represented mainly by mild cases with low complication rates and prominent genital involvement. The incidence in females and children was higher than usually reported. The observation of a bimodal distribution of Ct values, with few positive results, may suggest the need to review the diagnostic criteria in these groups.

Low-Temperature Synthesis of Magnetic Pyrochlores (R2Mn2O7, R = Y, Ho-Lu) at Ambient Pressure and Potential for High-Entropy Oxide Synthesis.

Rare-earth manganese pyrochlores (R2Mn2O7) are frustrated magnetic materials, which previously have only been accessed using expensive high-pressure and high-temperature synthesis. In the present work, we demonstrate a convenient synthetic approach to synthesize R2Mn2O7 pyrochlores at ambient pressure. A series of pyrochlores (R = Y, Ho-Lu) were prepared by a simple and cost-effective molten salt method using NaCl and KCl as the flux. Moreover, phase-selectivity was demonstrated for yttrium manganese oxides (YMnO3 and Y2Mn2O7) by a simple variation of synthesis temperature and precursors-to-chlorides ratio. The synthetic procedure does not require high pressures or temperatures nor oxygen flow. All synthesized pyrochlores demonstrated ferromagnetic behavior at low temperature, and the magnetic properties were in good agreement with those of high-pressure-synthesized materials. The versatility of the method was confirmed by the preparation of a mixed-rare earth Y0.4Er0.4Tm0.4Yb0.4Lu0.4Mn2O7 solid solution─a compositionally complex high-entropy oxide.

Genomic characterization of a novel SARS-CoV-2 lineage from Rio de Janeiro, Brazil.

Almost simultaneously, several studies reported the emergence of novel SARS-CoV-2 lineages characterized by their phylogenetic and genetic distinction (1), (2), (3), (4).….

Lanthanide Luminescence and Thermochromic Emission from Soft-Atom Donor Dichalcogenoimidodiphosphinate Ligands.

The luminescence properties of two divalent europium complexes of the type Eu[N(SPPh2)2]2(THF)2 (1) and Eu[N(SePPh2)2]2(THF)2 (2) were investigated. The first complex, Eu[N(SPPh2)2]2(THF)2 (1), was found to be isomorphous with the reported structure of complex 2 and exhibited room temperature luminescence with thermochromic emission upon cooling. We found the complex Eu[N(SePPh2)2]2(THF)2 (2) was also thermochromic but the emission intensity was sensitive to temperature. Both room temperature and low temperature (100 K) single crystal X-ray structural investigation of 1 and 2 indicate geometric distortions of the metal coordination, which may be important for understanding the thermochromic behavior of these complexes. The trivalent europium complex Eu[N(SPPh2)2]3 (3) with the same ligand as 1 was also structurally characterized as a function of temperature and exhibited temperature-dependent luminescence intensity, with no observable emission at room temperature but intense luminescence at 77 K. Variable temperature Raman spectroscopy was used to determine the onset temperature of luminescence of Eu[N(SPPh2)2]3 (3), where the 615 nm (5D0 → 7F2 transition) peak was quenched above 130 K. The UV-visible diffuse reflectance of 3 provides evidence of an LMCT band, supporting a mechanism of thermally activated LMCT quenching of Eu(III) emitting states. A series of ten isomorphous, trivalent lanthanide complexes of type Ln[N(SPPh2)2]3 (Ln = Eu (3) Pr (4), Nd (5), Sm (6), Gd (7), Tb (8)) and Ln[N(SePPh2)2]3 (Ln = Pr (9), Nd (10, structure was previously reported), Sm (11), and Gd (12) for Q = Se) were also synthesized and structurally characterized. These complexes for Ln = Pr, Nd, Sm, and Tb exhibited room temperature luminescence. This study provides examples of temperature-dependent luminescence of both Eu2+ and Eu3+, and the use of soft-atom donor ligands to sensitize lanthanide luminescence in a range of trivalent lanthanides, spanning near IR and visible emitters.

From a recombinant key antigen to an accurate, affordable serological test: Lessons learnt from COVID-19 for future pandemics.

Serological tests detect antibodies generated by infection or vaccination, and are indispensable tools along different phases of a pandemic, from early monitoring of pathogen spread up to seroepidemiological studies supporting immunization policies. This work discusses the development of an accurate and affordable COVID-19 antibody test, from production of a recombinant protein antigen up to test validation and economic analysis. We first developed a cost-effective, scalable technology to produce SARS-COV-2 spike protein and then used this antigen to develop an enzyme-linked immunosorbent assay (ELISA). A receiver operator characteristic (ROC) analysis allowed optimizing the cut-off and confirmed the high accuracy of the test: 98.6% specificity and 95% sensitivity for 11+ days after symptoms onset. We further showed that dried blood spots collected by finger pricking on simple test strips could replace conventional plasma/serum samples. A cost estimate was performed and revealed a final retail price in the range of one US dollar, reflecting the low cost of the ELISA test platform and the elimination of the need for venous blood sampling and refrigerated sample handling in clinical laboratories. The presented workflow can be completed in 4 months from first antigen expression to final test validation. It can be applied to other pathogens and in future pandemics, facilitating reliable and affordable seroepidemiological surveillance also in remote areas and in low-income countries.

The pleurogram, an under-investigated functional trait in seeds.

BACKGROUND: A structure called the pleurogram makes up a large part of the seed coat of some species in subfamilies Caesalpinioideae and Mimosoideae of Fabaceae, but little is known about its function. It has been hypothesized that this structure acts as a hygroscopic valve during the maturation drying of seeds. However, a new hypothesis has recently emerged that proposes a distinct function for the pleurogram. SCOPE: Here, we provide an overview of the structure and function of the pleurogram, which is diverse and complex. This large structure can be dislodged, thereby creating a pathway for water entry into water-impermeable seeds. However, the pleurogram is non-functional as a pathway of water into the seed of some species. Thus, the evolutionary history of species with a pleurogram may be related to a loss/gain in its function. A complete model for the function of the pleurogram is proposed. CONCLUSIONS: The pleurogram may act on several stages of the seed, from maturation to germination. As a hygroscopic valve, it regulates dehydration of the seed during maturation. As a pathway for water entry into the seed, the pleurogram acts as a water gap in seeds with physical dormancy, thereby regulating dormancy break/germination. The occurrence of a pleurogram in several genera of legumes and Cucurbitaceae is confirmed. Single or multiple pleurograms can serve as (the) point(s) of water entry into seeds that do not otherwise have a hilar water gap.

Study protocol: understanding the pathophysiologic mechanisms underlying delirium in older people undergoing hip fracture surgery.

BACKGROUND: Postoperative delirium (POD) is a common complication of older people undergoing hip fracture surgery, which negatively affects clinical- and healthcare-related outcomes. Unfortunately, POD pathophysiology is still largely unknown, despite previous studies showing that neuroinflammation, neuroendocrine dysfunction, increased reactive oxidative stress (ROS), and endothelial dysfunctions may be involved. There is also evidence that many of the pathophysiological mechanisms which are involved in delirium are involved in sarcopenia too. This article describes the protocol of a pilot study to evaluate the feasibility of a larger one that will explore the pathophysiological mechanisms correlating POD with sarcopenia. We will analyse whether various biomarkers reflecting neuroinflammation, ROS, neuroendocrine disorders, and microvasculature lesions will be simultaneously expressed in in the blood, cerebrospinal fluid (CSF), and muscles of patients developing POD. METHODS: Two centres will be involved in this study, each recruiting a convenient sample of ten older patients with hip fracture. All of them will undergo a baseline Comprehensive Geriatric Assessment, which will be used to construct a Rockwood-based Frailty Index (FI). Blood samples will be collected for each patient on the day of surgery and 1 day before. Additionally, CSF and muscle fragments will be taken and given to a biologist for subsequent analyses. The presence of POD will be assessed in each patient every morning until hospital discharge using the 4AT. Delirium subtypes and severity will be assessed using the Delirium Motor Subtype Scale-4 and the Delirium-O-Meter, respectively. We will also evaluate the patient's functional status at discharge, using the Cumulated Ambulation Score. DISCUSSION: This study will be the first to correlate biomarkers of blood, CSF, and muscle in older patients with hip fracture.

A new report of phytomelanin in cypselae of Vernonieae: the case of the type species of Lychnophora Mart.

Phytomelanin is a mechanically hard, blackish, and inert substance rarely found in plants. In Asteraceae, this substance was historically associated with the Heliantheae alliance, but recent studies have observed it in unrelated groups as Heterocoma and Wunderlichia. During a taxonomic investigation, we found phytomelanin in cypselae of Lychnophora salicifolia an unusual feature in Vernonieae previously found only in Heterocoma. Furthermore, phytomelanin fills the intercellular spaces of the sclerenchymatic outer mesocarp in L. salicifolia. Our results doubt the (syn)apomorphy status in Heterocoma, suggest the phytomelanin may have not the same evolutionary significance in Lychnophorinae as in other tribes and proposes new perspectives for evolutionary studies in Asteraceae.

Results of Ponseti Brasil Program: Multicentric Study in 1621 Feet: Preliminary Results.

BACKGROUND: The Ponseti method has been shown to be the most effective treatment for congenital clubfoot. The current challenge is to establish sustainable national clubfoot treatment programs that utilize the Ponseti method and integrate it within a nation's governmental health system. The Brazilian Ponseti Program (Programa Ponseti Brasil) has increased awareness of the utility of the Ponseti method and has trained >500 Brazilian orthopaedic surgeons in it. METHODS: A group of 18 of those surgeons had been able to reproduce the Ponseti clubfoot treatment, and compiled their initial results through structured spreadsheet. RESULTS: The study compiled 1040 patients for a total of 1621 feet. The average follow-up time was 2.3 years with an average correction time of approximately 3 months. Patients required an average of 6.40 casts to achieve correction. CONCLUSIONS: This study demonstrates that good initial correction rates are reproducible after training; from 1040 patients only 1.4% required a posteromedial release. LEVEL OF EVIDENCE: Level IV.

Roles of mucilage in Emilia fosbergii, a myxocarpic Asteraceae: Efficient seed imbibition and diaspore adhesion.

PREMISE OF THE STUDY: Several angiosperm families have myxodiaspory, such as the Asteraceae in which cypselae are frequently wind-dispersed. The roles of mucilage in cypselae remain misunderstood, and the route of water uptake from substrate to embryo remains unknown. In this work, we analyze the fruits of Emilia fosbergii aiming to clarify how the water is absorbed and how the structure of the pericarp can be related to the processes of diaspore adhesion and seed imbibition. METHODS: The anatomy and ultrastructure of the cypselae of Emilia fosbergii were analyzed with histochemical tests and light, scanning and transmission electron microscopy. We assessed the roles of mucilage in seed imbibition using apoplasmic tracing with Lucifer yellow and epifluorescence microscopy and in adhesion with a sand assay. KEY RESULTS: We describe structural and ultrastructural aspects of the exocarpic cells, especially the mucilaginous twin hairs. Lucifer yellow was absorbed only by the twin hairs, the cells where water primarily enters the seed during seed imbibition. In the sand assay, the mucilage was adhesive. CONCLUSIONS: The twin hairs on the surface of the cypselae can play a dual role in the establishment of new plants of this species. First, these trichomes constitute the main passage for water intake, which is essential for seed imbibition and germination, and after imbibition, they release mucilage that can adhere the diaspore. Therefore, the presence of myxocarpy in Asteraceae could be important in anemochoric species to avoid secondary dispersal.

Increasing use of less-invasive hemodynamic monitoring in 3 specialty surgical intensive care units: a 5-year experience at a tertiary medical center.

INTRODUCTION: Less-invasive hemodynamic monitoring (eg, esophageal doppler monitoring [EDM] and arterial pressure contour analysis, FloTrac) is increasingly used as an alternative to pulmonary artery catheters (PACs) in critically ill intensive care unit (ICU). HYPOTHESIS: The decrease in use of PACs is not associated with increased mortality. METHODS: Five-year retrospective review of 1894 hemodynamically monitored patients admitted to 3 surgical ICUs in a university-affiliate, tertiary care urban hospital. Data included the number of admissions, diagnosis-related group discharge case mix, length of stay, insertion of monitoring devices (PAC, EDM, and FloTrac probes), administered intravenous vasoactive agents (ß-predominant agonists--dobutamine, epinephrine, and dopamine; vasopressors--norepinephrine and phenylephrine), and mortality. Data from hospital administrative databases were compiled to create patient characteristic and monitoring variables across a 5-year time period, 2005 to 2009 inclusive. Chi-square for independent proportions, 1-way analysis of variance, and Kruskal-Wallis tests were used; tests for trend were conducted. An α level of .05 was considered significant. Statistical Package for the Social Sciences v14 was used for all statistical testing. RESULTS: There was a significant change in the type of hemodynamic monitors inserted in 2 of the 3 surgical ICUs (in the general surgery and neurointensive care but not in the cardiac ICU) from PACs to less-invasive devices (FloTrac or EDM) during the 5-year study period (P < .001). There was no change in mortality rate over the time period (P = .492). There was an overall increase in the proportion of monitored patients who received intravenous vasoactive agents (P < .001) with a progressive shift from ß-agonists to vasopressors (P < .002). Multivariate analyses indicated that age, case mix, and use of vasoactive agents were all independent predictors of inhospital mortality (P = .001) but that type of monitoring was not (P = .638). CONCLUSIONS: In a 5-year period, the decreased insertions of PACs were replaced by increased utilization of less-invasive hemodynamic monitoring devices. This change in practice did not adversely impact mortality.

Prevalence of hepatitis B and C markers in a population of an urban university in Rio de Janeiro, Brazil: a cross-sectional study.

BACKGROUND AND RATIONALE: Epidemics of hepatitis B and C are a public health burden, and their prevalence in Brazil varies among regions. We determined the prevalence of hepatitis markers in an urban university population in order to support the development of a comprehensive program for HBV immunization and HBV/HCV diagnosis. Students, employees, and visitors (n = 2,936, 31 years IQR 24.5-50, female = 69.0% and 81.1% with at least 12 years of education) were enrolled from May to November 2013. Antibodies against hepatitis B surface antigen (anti-HBs), against hepatitis B core antigen (anti-HBc), and hepatitis B surface antigen (HBsAg) were detected with enzyme immunoassays and anti-hepatitis C virus (anti-HCV) antibodies with a chemiluminescence immunoassay. The results were confirmed with polymerase chain reaction for HCV and nucleic acid amplification test for hepatitis B virus (HBV). RESULTS: The overall prevalence of markers among the participants was 0.136% (95% confidence interval [CI]: 0.003-0.270) for HBsAg, 6.44% (95% CI: 5.55-7.33%) for anti-HBc, 50.8% (95% CI: 48.9-52.7%) for anti-HBs > 10 mIU/mL, and 0.44% (95% CI: 0.20-0.68) for anti-HCV. Almost 30.4% had anti-HBs titers > 100 mIU/mL. Participants with a detectable HCV viral load (n = 9) were infected with genotype 1a. CONCLUSIONS: In an urban university population, in which 80% of participants had > 11 years of education, prevalence increased with age, and self-declared ethnicity for anti-HBc and with age, marital status and professional activity for anti-HCV antibodies. A periodical offer of HCV rapid testing should be implemented, and HBsAg rapid testing should be offered to individuals above 20 years of age.

Clinical, EEG, MRI, MEG, and surgical outcomes of pediatric epilepsy with astrocytic inclusions versus focal cortical dysplasia.

OBJECTIVE: Astrocytic inclusions (AIs) have been identified on histologic specimens of patients with early onset seizures, and the proteomic contents have been described. The aim of this study was to compare the clinical, electroencephalography (EEG), magnetoencephalography (MEG), magnetic resonance imaging (MRI), and surgical outcomes of AIs relative to focal cortical dysplasia (FCD). METHODS: We assessed the clinical manifestations, semiology, ictal and interictal features on video-EEG, MEG, MRI features, and surgical outcomes of children with histologically proven AIs compared to FCD. RESULTS: Six children had AIs and 27 had FCD. Children with AIs had an earlier age at seizure onset, periodic spasms (all children), and interictal epileptiform discharges consisting of a mixture of generalized or diffuse hemispheric slow waves, sharp waves, spikes and polyspikes. Children with FCD were less likely to have spasms (4/27 [15%]), and the morphology of the diffuse hemispheric or generalized discharges were different from those of AI, consisting of spike-and-waves, polyspike-and-waves, sharp-and-slow waves, and paroxysmal fast activity. Patients with AIs were less likely to have tightly clustered MEG spike sources (3/6 [50%] vs. 23/27 [85%]), and more likely to demonstrate abnormal sulcation and gyration pattern (4/6 [67%] vs. 2/27 [7%]) and gray matter heterotopia (2/6 [33%] vs. 0/27 [0%]) than patients with FCD. Four children with AIs had resection and two had biopsy but did not undergo resection. Children with AIs had lower rates of seizure freedom after surgery compared to FCD (1/4 [25%] vs. 15/27 [56%], respectively). SIGNIFICANCE: Although there were some similarities between AIs and FCD, patients with AIs were more likely to present with early onset periodic spasms, have unusual interictal epileptiform discharges, abnormal sulcation, gyration pattern, and gray matter heterotopia, and were less likely to be seizure free following surgical resection relative to FCD. Further study with a larger sample size is needed to validate our findings.

SPIDIA-RNA: first external quality assessment for the pre-analytical phase of blood samples used for RNA based analyses.

The diagnostic use of in vitro molecular assays can be limited by the lack of guidelines for collection, handling, stabilization and storage of patient specimens. One of the major goals of the EC funded project SPIDIA (www.spidia.eu) is to develop evidence-based quality guidelines for the pre-analytical phase of blood samples used for molecular testing which requires intracellular RNA analytes. To this end, a survey and a pan-European external quality assessment (EQA) were implemented. This report is the summary of the results of that trial. With the European Federation of Laboratory Medicine (EFLM) support, 124 applications for participation in the trial were received from 27 different European countries, and 102 laboratories actually participated in the trial. Each participating laboratory described their respective laboratory policies and practices as well as blood collection tubes typically used in performing this type of testing. The participating laboratories received two identical blood specimens: in an EDTA tubes (unstabilized blood; n=67) or in tubes designed specifically for the stabilization of intracellular RNA in blood (PAXgene® Blood RNA tubes; n=35). Laboratories were requested to perform RNA extraction according to the laboratory's own procedure as soon as possible upon receipt of the tubes for one tube and 24h after the first extraction for the second tube. Participants (n=93) returned the two extracted RNAs to SPIDIA facility for analysis, and provided details about the reagents and protocols they used for the extraction. At the SPIDIA facility responsible for coordinating the study, the survey data were classified, and the extracted RNA samples were evaluated for purity, yield, integrity, stability, and the presence of interfering substances affecting RT-qPCR assays. All participants received a report comparing the performance of the RNA they submitted to that of the other participants. All the results obtained by participants for each RNA quality parameter were classified as "in control", "warning", "out of control" and "missing" by consensus mean analysis. From the survey data, the most variable parameters were the volume of blood collected and the time and storage temperature between blood collection and RNA extraction. Analyzing the results of quality testing of submitted RNA samples we observed a data distribution of purity, yield, and presence of assay interference in agreement with expected values. The RNA Integrity Number (RIN) values distribution was, on the other hand, much wider than the optimal expected value, which led to an "in control" classification, even for partly degraded RNA samples. On the other hand, RIN values below 5 significantly correlated with a reduction of GAPDH expression levels. Furthermore, the distribution of the values of the four transcripts investigated (c-fos, IL-1ß, IL-8, and GAPDH) was wide and the RNA instability between samples separated by 24h were similar. Assuming the presence of at least two quality parameters "out of control" as an indication of a critical performance of the laboratory, 33% of the laboratories were included in this group. The results of this study will be the basis for implementing a second pan-European EQA and the results of both EQAs will be pooled and will provide the basis for the implementation of evidence-based guidelines for the pre-analytical phase of RNA analysis of blood samples.

Eligible offender samples are missing in CODIS: A statewide approach to performing a lawfully owed DNA census.

In 2019, the Texas Department of Public Safety (TXDPS) Texas Ranger Division (TRD) identified approximately 3300 registered sex offenders (RSOs) from whom a "lawfully owed" DNA sample was missing from the Federal Bureau of Investigation's Combined DNA Index System (CODIS). Lawfully owed DNA (LODNA) is defined as a DNA sample from a qualifying offender who should have had their sample entered into CODIS, but for unknown reasons did not. As a result of those findings, TXDPS then applied for and was awarded a grant from the Bureau of Justice Assistance's Sexual Assault Kit Initiative to collect DNA specimens from these RSOs, and to perform a statewide LODNA census. TXDPS TRD sought to determine: Are the missed DNA collection problems limited to RSO's or are they occurring among individuals with a qualifying arrest or conviction as specified by state law too? What processes are used to identify individuals who are eligible for DNA sample collection? How is an individuals' DNA collection eligibility conveyed to external agencies? The findings from TXDPS' LODNA census, identified 43,245 individuals who were likely eligible for DNA collection between 1995 and 2020, therefore indicating statewide DNA collection issues. Over 4 years, collection efforts pertaining to the aforementioned lawfully owed census, have yielded 5183 LODNA sample collections, and 276 CODIS hits. This manuscript aims to create an awareness within other agencies of the importance of implementing best practices to ensure the collection and upload of LODNA from every eligible individual.

Immunoglobulin A as a Key Immunological Molecular Signature of Post-COVID-19 Conditions.

COVID-19 has infected humans worldwide, causing millions of deaths or prolonged symptoms in survivors. The transient or persistent symptoms after SARS-CoV-2 infection have been defined as post-COVID-19 conditions (PCC). We conducted a study of 151 Brazilian PCC patients to analyze symptoms and immunoglobulin profiles, taking into account sex, vaccination, hospitalization, and age. Fatigue and myalgia were the most common symptoms, and lack of vaccination, hospitalization, and neuropsychiatric and metabolic comorbidities were relevant to the development of PCC. Analysis of serological immunoglobulins showed that IgA was higher in PCC patients, especially in the adult and elderly groups. Also, non-hospitalized and hospitalized PCC patients produced high and similar levels of IgA. Our results indicated that the detection of IgA antibodies against SARS-CoV-2 during the course of the disease could be associated with the development of PCC and may be an immunological signature to predict prolonged symptoms in COVID-19 patients.

Effects of vitamin D supplementation on glycemic control of children and adolescents with type 1 diabetes mellitus: a systematic review.

OBJECTIVES: To evaluate the effect of vitamin D supplementation on glycemic control in children and adolescents with T1DM. CONTENT: A systematic search was conducted of the Medline/PubMed, Web of Science, Embase, BVS/Lilacs, Cochrane Library, Scopus, Cinahl, Food Science, and FSTA databases. Two reviewers independently extracted article data and assessed quality. SUMMARY: A total of 1,613 eligible articles were retrieved, ten of which met the selection criteria: eight clinical trials, one retrospective cohort study, and one cross-sectional study. Regarding the cutoff points used to classify vitamin D status, most of the studies set deficiency at 25-hydroxyvitamin D <20 ng/mL, sufficiency at ≥30 ng/mL, and insufficiency as the interval between these values. Regarding intervention strategies, most used cholecalciferol for supplementation, but there was great variation in the dose and supplementation time. When evaluating the effect of vitamin D supplementation on HbA1c, a significant improvement in glycemic control was observed in 50% of the studies. However, only one of these studies was classified as being of positive methodological quality, with three having their quality classified as neutral and one as negative. OUTLOOK: There is yet no consistent evidence on the effect of vitamin D supplementation on glycemic control as an adjuvant in the treatment of children and adolescents with T1DM.