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Septic arthritis of the temporomandibular joint (SATMJ), primarily caused by bacterial infections, is a rare condition with a diverse etiology that is inadequately documented in the literature, resulting in the absence of standardized treatment protocols. Its nonspecific clinical presentation often leads to misdiagnosis as other temporomandibular disorders, delaying diagnosis and treatment and potentially causing severe complications in the absence of established therapeutic guidelines. The main objective of this article is to report a case of a 61-year-old female with diabetes who was undergoing prolonged corticosteroid therapy and presented with pain, swelling in the right pre-auricular area, and progressive limitation in mouth opening, with no history of facial trauma, where the early diagnosis and isolation of Staphylococcus aureus after a single-port arthrocentesis prompted the timely adjustment of the treatment regimen, significantly influencing the outcome by mitigating the risk of complications. Additionally, this report includes a comprehensive literature review, highlighting the crucial importance of this prompt intervention to achieve a favorable clinical outcome.
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The aim of this study was to investigate the effect of 6-weeks resistance training (RT) on appetite, energy intake and body composition in young women with and without obesity, and to examine the relationship between these variables. Thirty-five young women were divided according to the amount of body fat [with obesity (n=16) and without obesity (n=19)]. Appetite was assessed through self-reported hunger, fullness, desire to eat, satiety quotient, food frequency diary and motivations to eat palatable food (power of food scale) in both fasted and fed states (after a standardized breakfast). Energy intake and body composition were evaluated at pre- and post-6 weeks of RT. Results showed that self-reported hunger increased significantly in both fasted and fed states (p=0.007 and p=0.029, respectively), while self-reported fullness decreased at the fasted state (p=0.030) in both groups. There were no significant effects for desire to eat fatty, sweet, savory and salty foods, motivation to eat palatable foods, or for total energy intake. Food frequency analysis indicated a decrease in consumption of soup and past (p=0.045), vegetables and eggs (p=0.034), and leafy vegetables (p=0.022) in both groups. Fat-free mass increased significantly in both groups (p=0.011 and p=0.003), while fat mass did not show significant changes. There were no correlations between changes in appetite/energy intake and changes in body composition. In conclusion, following the 6-week RT program, both women with and without obesity exhibited increased self-reported hunger alongside decreased fullness, suggesting an increase in orexigenic drive. However, neither group showed an increase in energy intake and fat mass, while both groups experienced an increase in fat-free mass. Registered under Brazilian Registry of Clinical Trials n°. RBR-1024f4qs.
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Introduction: Rituximab (RTX) has been reported as an effective treatment alternative in primary forms of minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) associated with steroid dependence and frequent relapses. However, the optimal RTX regimen and the outcomes of further doses of RTX remain unclear. This study aimed to evaluate the use of induction and maintenance RTX therapy for adults with primary podocytopathies. Methods: We performed a retrospective case series on adult patients with steroid-dependent podocytopathies who received an induction RTX therapy. Maintenance therapy was performed at physician's discretion. Remission and relapse rates, concomitant corticosteroids and immunosuppressants use, B-cell depletion and adverse events were analyzed. Results: Fourteen patients (mean age at start of RTX 29.1 ± 21.9 years) with MCD (n = 7) or FSGS (n = 7) were treated with 2 doses of 1,000 mg 2 weeks apart (n = 13) or four doses of 375 mg/m2 (n = 1) of RTX. At last follow-up (mean 47.3 ± 101.7 months), 10 patients were in complete remission and two remained in partial remission. A reduction in the number of relapses, number of patients under corticosteroids and immunosuppressants, and dose of prednisolone was observed when compared to baseline (14 [100%] vs. 5 [35.7%]; 8/14 [57.1%] vs. 4/12 [33.3%]; 13/14 [92.9%] vs. 7/12 [58.3%]; 20 mg/day vs. 5.25 mg/day, respectively). Maintenance RTX therapy was used in 6 patients, with sustained complete remission. Infusion reactions were observed in 4 patients (one required treatment withdrawal). Conclusions: Our findings support the use of RTX for a steroid-free remission in podocytopathies and suggest that maintenance RTX is well-tolerated and associated with prolonged remission. Further studies are needed to confirm its efficacy and safety and establish the optimal induction and maintenance RTX regimen in steroid-dependent podocytopathies.
Rituximab (RTX) seems to be an effective treatment alternative in primary forms of MCD and FSGS, particularly in cases of steroid dependence and frequent relapses. Our findings support the use of RTX for a steroid-free remission in podocytopathies and suggest that maintenance RTX is well-tolerated and associated with prolonged remission. Further studies are needed to confirm its efficacy and safety and establish the optimal induction and maintenance RTX regimen in steroid-dependent podocytopathies.
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The quest for sustainable strategies in molecular synthesis has spurred the emergence of photocatalysis as a particularly powerful technique. In recent years, the application of photocatalysis in this context has greatly promoted the development of asymmetric catalysis. Despite the impressive advances, enantioselective photoinduced strong arene C-H activations by cobalt catalysis remain unexplored. Herein, we report a strategy that merges organic photoredox catalysis and enantioselective cobalt-catalyzed C-H activation, enabling the regio- and stereoselective dual functionalization of indoles in an enantioselective fashion. Thereby, the assembly of various chiral indolo[2,3-c]isoquinolin-5-ones was realized with high enantioselectivities of up to 99%. The robustness of the cobaltaphotoredox catalysis was demonstrated through enantioselective C-H activation and annulations in a continuous flow to provide straightforward access to central and axially chiral molecules.
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Mitochondrial cytopathies can have kidney involvement in up to half of cases. Their diagnosis is challenging due to phenotypic variability, lack of noninvasive tests to assess mitochondrial dysfunction and genetic heterogeneity. We report on a young adult male with hypertrophic cardiomyopathy (HCM) and chronic kidney disease (CKD) with sub-nephrotic proteinuria, who presented to the emergency department with kidney failure and hypervolemia requiring dialysis. A kidney biopsy showed focal segmental and global glomerulosclerosis, extensive foot process effacement, and abnormal mitochondria in podocytes and tubular epithelial cells; the genetic workup identified a rare FASTKD2 exon 2 variant, c.29G>C p.(Ser10Thr), in homozygosity; and functional mitochondrial assays in cultured skin fibroblasts showed reduction in FASTKD2 protein expression and moderate combined impairment in mitochondrial respiratory chain (MRC) assembly and function. This is the first report of a FASTKD2-associated cardiorenal mitochondrial cytopathy, characterized by young adult-onset proteinuric CKD and dilated HCM, in the absence of the severe neurologic manifestations described in patients with biallelic FASTKD2 mutations. We hypothesize that the increased production of reactive oxygen species associated with moderate MRC impairment could result in a smoldering podocytopathy with progressive proteinuric CKD, without overt tubulopathy or encephalomyopathy, which are, instead, pathogenically related to adenosine triphosphate deficiency.
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Continuous-time asynchronous data converters namely, analog-to-digital converters and analog-to-time converters, can be beneficial for certain types of applications, such as, processing of biological signals with sparse information. A particular case of these converters is the integrate-and-fire converter (IFC) that is inspired by the neural system. If it is possible to develop a standard-cell-based (SCB) IFC circuit to perform well in advanced technology nodes, it will benefit from the simplicity of SCB circuit designs and can be implemented in widely available field-programmable gate arrays (FPGAs). This way, this paper proposes two IFC circuits designed and prototyped in a 130 nm CMOS standard process. The first is a novel SCB open-loop dynamic IFC. The latter, is a closed-loop analog IFC with conventional blocks. This paper presents a through comparison between the two IFC circuits. They have a power dissipation of 59 µW and 53 µW, and an energy per pulse of 18 pJ and 1060 pJ, SCB and analog IFC, respectively. The SCB IFC has one of the lowest energy per pulse consumption reported for IFC circuits. The analog IFC, being fully differential, is to our knowledge the first of its kind. Moreover, they do not require an external clock. They can convert signals with a peak-to-peak amplitude from 1.6 mV to 28 mV and 0.6 mV to 2.4 mV, and a frequency range of 2 Hz to 42 kHz and 10 Hz to 4 kHz, SCB and analog IFC, respectively. Presenting low normalized RMS conversion plus reconstruction errors, below 5.2 %. The maximum pulse density (average firing-rate) is 3300 kHz, for the SCB and 50 kHz, for the analog IFC.
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Skeletal molecular editing gained considerable recent momentum and emerged as a uniquely powerful tool for late-stage diversifications. Thus far, superstoichiometric amounts of costly hypervalent iodine(III) reagents were largely required for skeletal indole editing. In contrast, we herein show that electricity enables sustainable nitrogen atom insertion reactions to give bio-relevant quinazoline scaffolds without stoichiometric chemical redox-waste product. The transition metal-free electro-editing was enabled by the oxygen reduction reaction (ORR) and proved robust on scale, while tolerating a variety of valuable functional groups.
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Polygenic risk scores (PRSs) for breast cancer have a clear clinical utility in risk prediction. PRS transferability across populations and ancestry groups is hampered by population-specific factors, ultimately leading to differences in variant effects, such as linkage disequilibrium and differences in variant frequency (allele frequency differences). Thus, locally sourced population-based phenotypic and genomic data sets are essential to assess the validity of PRSs derived from signals detected across populations. Here, we assess the transferability of a breast cancer PRS composed of 313 risk variants (313-PRS) in a Brazilian trihybrid admixed ancestries (European, African, and Native American) whole-genome sequenced cohort, the Rare Genomes Project. We computed 313-PRS in the Rare Genomes Project (n = 853) using the UK Biobank (UKBB; n = 264,307) as reference. We show that although the Brazilian cohorts have a high European ancestry (EA) component, with allele frequency differences and to a lesser extent linkage disequilibrium patterns similar to those found in EA populations, the 313-PRS distribution is inflated when compared with that of the UKBB, leading to potential overestimation of PRS-based risk if EA is taken as a standard. Interestingly, we find that case controls lead to equivalent predictive power when compared with UKBB-EA samples with area under the receiver operating characteristic curve values of 0.66 to 0.62 compared with 0.63 for UKBB.
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Norovirus is an important etiologic agent of acute gastroenteritis and has become even more relevant in Brazil after the implementation of the monovalent rotavirus vaccine in 2006 through the public health system, now representing a significant portion of the etiology of acute diarrheal diseases. Although diagnosing acute gastroenteritis caused by norovirus is a relatively simple process, and the infection tends to be self-limited, the virus can be considerably harmful to vulnerable populations, such as children, the elderly, and immunocompromised individuals. The spread of norovirus is also particularly favorable among such groups due to its mode of transmission, favored by cluttered environments such as in hospitals and densely populated regions. Additionally, norovirus' ability to spread through water and food creates the need for measures to ensure adequate sanitation and the development of effective measures to prevent outbreaks and severe manifestations of the disease. This review aims to address the main reports of human norovirus detected in Brazil over the years, focusing on clinical-hospital, food-related, and urban conglomerate contexts, including the circulating strains.
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With the growing demand for sustainable and safe agricultural practices, plant compounds emerge as a solution for biological activities. Here, we evaluated the potential of using Morinda citrifolia essential oil to induce plant resistance and to control phytopathogens (Curvularia lunata) and insect pests (Daubulus maidis). We conducted a chromatographic analysis to unveil the essential oil components. We also quantified the activity levels of antioxidant enzymes and chitinase for resistance induction. The antifungal action was evaluated through disease progression and the inhibition of mycelial growth in addition to in silico studies that made it possible to predict the interaction site between the fungal protein and the compounds. We assessed the toxicity and repellent actions towards the D. maidis. Octanoic acid (58.43%) was identified as the essential oil major compound. Preventive treatment with essential oil and octanoic acid (25.0 µL mL-1) increased not only the plant defense activities (i.e., the activity of the enzymes superoxide dismutase, catalase, phenol peroxidase, ascorbate peroxidase, and chitinase) but also controlled Curvularia leaf spot. The stable interactions between octanoic acid and tyrosine-tRNA ligase from C. lunata suggested protein synthesis inactivation. The essential oil inhibited 51.6% of mycelial growth, and this effect was increased to 75.9% with the addition of adjuvants (i.e., angico gum). The essential oil reduced 76% of the population of D. maidis adults and repelled 50% of the number of D. maidis after 48 h under field conditions. The repellency effect in the field reduced the population of D. maidis adults, transmitters of the stunting complex, by 50%. The results highlight the potential of M. citrifolia as a resistance activator, fungicide, insecticide, and an effective biorational alternative.
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Futsal carries a high risk of injury for players. This systematic review aimed to assess the existing literature on injury prevention strategies for futsal players. The literature was searched using PubMed, Web of Science, and Scopus databases from inception to 20 March 2024. Relevant articles were searched using the terms "futsal" AND "injury" AND "prevention". Fourteen studies were included in the review. The review identified several injury prevention strategies with potential benefits for futsal players. Structured warm-up routines were shown to improve balance and eccentric strength and to reduce total, acute, and lower limb injuries. Proprioceptive training methods were suggested to improve joint stability and landing mechanics, which may reduce the risk of injury. Furthermore, multicomponent methods that include components such as core stability and flexibility have shown potential for reducing injury rates in futsal players. Finally, by reducing fatigue and improving movement control, strength training procedures designed to correct muscular imbalances may improve performance, which may ultimately minimize the risk of injury. This systematic review demonstrates the potential benefits of different injury prevention strategies for futsal players. The combination of several strategies, such as proprioceptive training, multicomponent programs, warm-up routines, and strength training specifically designed to address muscular imbalances, appears promising.
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A proposal for taxonomic species description notation is presented to replace the traditional descriptive texts for a coded matrix, avoiding redundant adjectives and subjective descriptions. This is an attempt to enhance the species description rate and to make the descriptions output available to other scientific disciplines, machine learning, interactive and computer-assisted identification keys, metadata analysis and its applications. The method consists of presenting the description of the overall morphology in a coded matrix, following a character list with detailed observed conditions for each character. The method is dynamic and open to amendments and new data addition as they become available. We test the new method describing five new species of Collembola Symphypleona of the genus Pararrhopalites as a generalized model and made the coded output available. We conclude that a coded taxonomic description is an advance to the traditional taxonomic text, with potential to enhance the global descriptions rate. The generated descriptions are dynamic, expandable and can be easily used in other fields of science, allowing non-experts to access the data for phylogenetic, biogeographic, ecological studies and metadata analysis. Even though an experienced taxonomist will always be necessary to make a detailed taxonomic description, it is a step forward to a general template to semi-automated taxon recognition and to future development of auxiliary tools for species description using machine learning and templates to speed up the time-consuming phase of schematic figures preparation, after the expert interpretations are done.
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OBJECTIVE: to analyze the safety attitudes of health and support areas professionals working in Surgical Center. METHOD: sequential explanatory mixed methods study. The quantitative stage covered 172 health and support professionals in eight Surgical Centers of a hospital complex. The Safety Attitudes Questionnaire/Surgical Center was applied. In the subsequent qualitative stage, 16 professionals participated in the Focus Group. Photographic methods were used from the perspective of ecological and restorative thinking, and data analysis occurred in an integrated manner, through connection. RESULTS: the general score, by group of Surgical Centers, based on the domains of the Safety Attitudes Questionnaire/Surgical Center, reveals a favorable perception of the safety climate, with emphasis on the domains Stress Perception, Communication in the Surgical Environment, Safety Climate and Perception of Professional Performance. The overall analysis of the domain Communication and Collaboration between Teams appears positive and is corroborated by data from the qualitative stage, which highlights the importance of interaction and communication between healthcare teams as fundamental for daily work. CONCLUSION: the perception of safety attitudes among health and support professionals was positive. The perception of the nursing team stands out as closer or more favorable to attitudes consistent with the safety culture.
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Actitud del Personal de Salud , Administración de la Seguridad , Humanos , Administración de la Seguridad/normas , Femenino , Masculino , Seguridad del Paciente/normas , Adulto , Centros Quirúrgicos/normas , Centros Quirúrgicos/organización & administración , Cultura Organizacional , Persona de Mediana EdadRESUMEN
INTRODUCTION: Research quality within the neurosurgical field remains suboptimal. Therefore, many studies published in the neurosurgical literature lack enough statistical power to establish the presence or absence of clinically important differences between treatment arms. The field of neurotrauma deals with additional challenges, with fewer financial incentives and restricted resources in low-income and middle-income countries with the highest burden of neurotrauma diseases. In this systematic review, we aim to estimate the prevalence of false claims of equivalence in the neurosurgical trauma literature and identify its predictive factors. METHODS AND ANALYSIS: The Preferred Reporting Items for Systematic Review and Meta-Analyses recommendations were followed. Randomised clinical trials that enrolled only traumatic brain injury patients and investigated any type of intervention (surgical or non-surgical) will be eligible for inclusion. The MEDLINE/PubMed database will be searched for articles in English published from January 1960 to July 2020 in 15 top-ranked journals. A false claim of equivalence will be identified by insufficient power to detect a clinically meaningful effect: for categorical outcomes, a difference of at least 25% and 50%, and for continuous outcomes, a Cohen's d of at least 0.5 and 0.8. Using the number of patients in each treatment arm and the minimum effect sizes to be detected, the power of each study will be calculated with the assumption of a two-tailed alpha that equals 0.05. Standardised differences between the groups with and without a false claim of equivalence will be calculated, and the variables with a standardised difference equal or above 0.2 and 0.5 will be considered weakly and strongly associated with false claims of equivalence, respectively. The data analysis will be blinded to the authors and institutions of the studies. ETHICS AND DISSEMINATION: This study will not involve primary data collection. Therefore, formal ethical approval will not be required. The final systematic review will be published in a peer-reviewed journal and presented at appropriate conferences.
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Lesiones Traumáticas del Encéfalo , Revisiones Sistemáticas como Asunto , Humanos , Lesiones Traumáticas del Encéfalo/cirugía , Lesiones Traumáticas del Encéfalo/epidemiología , Procedimientos Neuroquirúrgicos , Proyectos de Investigación , Ensayos Clínicos Controlados Aleatorios como Asunto , PrevalenciaRESUMEN
PURPOSE: According to previous biomechanical studies, the success of meniscus root repair depends on the suture-meniscus interface and optimisation of this procedure seems to be critical. A progressive, reliable and adjustable knot has numerous advantages in meniscal repair since the surgeon can adapt and meticulously tune the final strength of the fixation. We hypothesised that a single passage of one tape at two different points of the posterior meniscal root with a modified Nice knot configuration may allow similar or superior fixation for root repair compared to the cinch stitch suture technique. METHODS: Posterior root repair of medial and lateral meniscus was performed on 26 porcine knees. In group (A), two simple cinch stitches were applied, and in group (B), a modified Nice knot was used in a crossmatch configuration. For both groups, two passages through the meniscus with a 2-mm braided tape were used, and a single transosseous tibial tunnel technique was performed and tested in pull-out conditions. RESULTS: The modified Nice knot showed an improved biomechanical performance considering the maximum failure load for both the medial (600.7 ± 77.5 N) and lateral (686.1 ± 83.5 N) (p = 0.006) posterior root fixation when compared to a double cinch stitch (558.0 ± 123.9 N) and (629.0 ± 110.2 N) (p = 0.178) for medial and lateral fixation, respectively. The maximum stiffness was also higher for the modified Nice knot configuration for both medial (17.1 ± 1.5 vs. 13.3 ± 1.6 N/mm) and lateral meniscus (20.0 ± 2.6 vs. 13.8 ± 2.3 N/mm), being this difference statistically significative (p = 0.001). CONCLUSIONS: The modified Nice knot allowed better adaptation in the pull-out tests and presented higher fixation strength, stiffness and reproducibility, with lower standard deviation, being at the same time economically advantageous, since only one tape is needed. LEVEL OF EVIDENCE: Level III.
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Flavonoids are compounds that result from the secondary metabolism of plants and play a crucial role in plant development and mitigating biotic and abiotic stresses. The highest levels of flavonoids are found in legumes such as soybean. Breeding programs aim to increase desirable traits, such as higher flavonoid contents and vigorous seeds. Soybeans are one of the richest sources of protein in the plant kingdom and the main source of flavonoid derivatives for human health. In view of this, the hypothesis of this study is based on the possibility that the concentration of isoflavones in soybean seeds contributes to the physiological quality of the seeds. The aim of this study was to analyze the content of flavonoids in soybean genotypes and their influence on the physiological quality of the seeds. Seeds from thirty-two soybean genotypes were obtained by carrying out a field experiment during the 2021/22 crop season. The experimental design was randomized blocks with four replications and thirty-two F3 soybean populations. The seeds obtained were subjected to germination, first germination counting, electrical conductivity and tetrazolium vigor and viability tests. After drying and milling the material from each genotype, liquid chromatography analysis was carried out to obtain flavonoids, performed at UPLC level. Data were submitted to analysis of variance and, when significant, the means were compared using the Scott-Knott test at 5% probability. The results found here show the occurrence of genotypes with higher amounts of flavonoids when compared to their peers. The flavonoid FLVD_G2 had the highest concentration and differed from the others. Thus, we can assume that the type and concentration of flavonoids does not influence the physiological quality of seeds from different soybean genotypes, but it does indirectly contribute to viability and vigor, since the genotypes with the highest FLVD_G2 levels had better FGC values. The findings indicate that there is a difference between the content of flavonoids in soybean genotypes, with a higher content of genistein. The content of flavonoids does not influence the physiological quality of seeds, but contributes to increasing viability and vigor.
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Flavonoides , Genotipo , Germinación , Glycine max , Semillas , Glycine max/genética , Glycine max/metabolismo , Glycine max/crecimiento & desarrollo , Semillas/genética , Flavonoides/análisis , Flavonoides/metabolismo , Isoflavonas/análisis , Isoflavonas/metabolismoRESUMEN
Purpose: To identify biomarkers in human blood or urine at an early stage of knee osteoarthritis (OA) and to elucidate if any can accurately differentiate between healthy controls and early knee OA patients and be considered as a candidate for widespread clinical use for early diagnosis of the disease. Methods: Medline, Embase and Web of Science were screened to identify comparative studies measuring differences in blood or urine biomarkers between healthy controls and knee OA patients at an early stage (grade 1 or 2 Kellgren-Laurence). Two independent reviewers screened the abstracts for eligibility, reviewed the full texts, assessed the methodological quality and extracted the data. The Joanna Briggs Institute critical appraisal tool for diagnostic test accuracy studies was used to assess the quality of the included studies. Due to relevant heterogeneity, meta-analysis was not appropriate. Results: Five studies met the eligibility criteria. The examined biomarkers were adropin, collagen type II metabolite, C-terminal cross-linked telopeptide of type II collagen, C-terminal cross-linked telopeptide of type I collagen, cartilage oligomeric matrix protein, matrix metalloproteinase 3, N-terminal propeptide of procollagen type IIA, type I procollagen N-terminal propeptides, N-terminal osteocalcin, angiopoietin-2, follistatin, granulocyte colony-stimulating factor, hepatocyte growth factor, interleukin-8, leptin, platelet-derived growth factor-BB, platelet endothelial cell adhesion molecule-1, vascular endothelial growth factor and calprotectin and totalling 19 biomarkers. All of the biomarkers were studied only once in the selected papers. Conclusions: There is no reliable biomarker available to differentiate between early knee OA in patients and healthy controls, but a potential role of a cluster of biomarkers to close this gap. There are several limitations, including inappropriate study designs, small sample sizes, nonconsecutive patient groups and inadequate statistical methods for evaluating biomarker performance in studies included. Level of Evidence: Level III.
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Some bacteria have developed mechanisms to withstand the stress caused by ionizing radiation. The ability of these radioresistant microorganisms to survive high levels of radiation is primarily attributed to their DNA repair mechanisms and the production of protective metabolites. To determine the effect of irradiation on bacterial growth, we propose to compare the metabolites produced by the irradiated isolates to those of the control (non-irradiated isolates) using mass spectrometry, molecular networking, and chemometric analysis. We identified the secondary metabolites produced by these bacteria and observed variations in growth following irradiation. Notably, after 48 h of exposure to radiation, Pantoea sp. bacterial cells exhibited a significant 6-log increase compared to non-irradiated cells. Non-irradiated cells produce exclusively Pyridindolol, 1-hydroxy-4-methylcarbostyril, N-alkyl, and N-2-alkoxyethyl diethanolamine, while 5'-methylthioadenosine was detected only in irradiated cells. These findings suggest that the metabolic profile of Pantoea sp. remained relatively stable. The results obtained from this study have the potential to facilitate the development of innovative strategies for harnessing the capabilities of endophytic bacteria in radiological protection and bioremediation of radionuclides.