Hearing Function after CyberKnife for Vestibular Schwannoma: A Systematic Review.

Introduction CyberKnife (CK) radiosurgery is a treatment strategy for vestibular schwannoma (VS). Objectives To evaluate hearing preservation (HP) after CK for VS. Data Synthesis The study was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, and it was registered at the International Prospective Register of Systematic Reviews (PROSPERO, under number CRD42021250300). The inclusion criteria were based on the population, intervention, comparison, outcome, timing and study design (PICOTS) strategy: population - patients with VS; intervention - CK; Comparison - none; Outcome - serviceable HP defined by Gardner and Robertson as grades I or II, or by the American Academy of Otolaryngology and Head and Neck Surgery as classes A or B; timing - mean follow-up longer than 1 year; and study design - retrospective or prospective studies. The exclusion criteria were: studies not published in English; studies published before January 2000 and after October 2021; and studies only including patients with neurofibromatosis type 2 or submitted to a previous treatment. The PubMed/MEDLINE, EMBASE, Web of Science, Cochrane Library, LILACS, and IBECS databases were used and last searched on October 27th, 2021. Statistical heterogeneity was assessed using I 2 statistics. The appraisal checklist was used to assess the risk of bias in the included studies. A total of 222 studies were analyzed, and 13 were included in the synthesis, which represents 493 participants with serviceable hearing before intervention. The mean HP rate after CK using a random effects model was of 68% (95% confidence interval [95%CI]: 59-76%) at a mean follow-up of 42.96 months. Conclusion The longer follow-up period was associated with a lower HP rate after CK radiosurgery for VS in the qualitative synthesis.

Effects of vitamin D supplementation on metabolic syndrome parameters in patients with obesity or diabetes in Brazil, Europe, and the United States: A systematic review and meta-analysis.

Plasma 25-dihydroxyvitamin D levels appear reduced in patients with obesity or type 2 diabetes, as reported in several observational studies. However, the association between these reduced hormone levels and metabolic parameters is unclear. In any case, vitamin D supplementation in patients with Metabolic Syndrome is standard. Still, the impacts of this supplementation on conditions such as glycemia, blood pressure, and lipidemia are debatable. Based on this question, we carried out a systematic review and meta-analysis of randomized clinical trials in Brazil, Europe, and the United States that analyzed the effects of vitamin D supplementation on Metabolic Syndrome parameters in patients with obesity or type 2 diabetes. Our search yielded 519 articles and included 12 randomized controlled trials in the meta-analysis. Vitamin D supplementation had no effect on any of the outcomes analyzed (fasting blood glucose and insulinemia, glycated hemoglobin, HOMA index, systolic and diastolic blood pressure, weight, waist circumference, total cholesterol, LDL and HDL, and triglycerides). However, subgroup analyses indicated that using vitamin D up to 2000 IU daily reduced participants' fasting blood glucose and glycated hemoglobin. Furthermore, the intervention reduced diastolic blood pressure only in participants with vitamin D deficiency. At least two studies showed a high risk of bias using the Rob2 protocol. According to the GRADE protocol, the evidence quality varied from moderate to very low. These results indicate that vitamin D supplementation does not improve patients' metabolic parameters and that the association between plasma 25-dihydroxyvitamin D levels and Metabolic Syndrome may not be causal but caused by other confounding characteristics. However, in any case, the quality of evidence is still low, and more randomized clinical trials are essential to clarify these relationships.

Semi-empirical models for remote estimating colored dissolved organic matter (CDOM) in a productive tropical estuary.

Inland waters are important components of the global carbon cycle as they regulate the flow of terrestrial carbon to the oceans. In this context, remote monitoring of Colored Dissolved Organic Matter (CDOM) allows for analyzing the carbon content in aquatic systems. In this study, we develop semi-empirical models for remote estimation of the CDOM absorption coefficient at 400 nm (aCDOM) in a tropical estuarine-lagunar productive system using spectral reflectance data. Two-band ratio models usually work well for this task, but studies have added more bands to the models to reduce interfering signals, so in addition to the two-band ratio models, we tested three- and four-band ratios. We used a genetic algorithm (GA) to search for the best combination of bands, and found that adding more bands did not provide performance gains, showing that the proper choice of bands is more important. NIR-Green models outperformed Red-Blue models. A two-band NIR-Green model showed the best results (R2 = 0.82, RMSE = 0.22 m-1, and MAPE = 5.85%) using field hyperspectral data. Furthermore, we evaluated the potential application for Sentinel-2 bands, especially using the B5/B3, Log(B5/B3) and Log(B6/B2) band ratios. However, it is still necessary to further explore the influence of atmospheric correction (AC) to estimate the aCDOM using satellite data.

Development of a Versatile Toolbox for Genetic Manipulation of Sporothrix brasiliensis.

Sporothrix brasiliensis has emerged as the most virulent species in the Sporothrix schenckii complex, accounting for sporotrichosis. Albeit the new insights into the understanding of host-pathogen interactions and comparative genomics of this fungi, the lack of genetic tools has hindered significant advances in this field of research. Here, we established an Agrobacterium tumefaciens-mediated transformation (ATMT) system to transform different strains of S. brasiliensis. We report parameters that account for a transformation efficiency of 3,179 ± 1,171 transformants/co-cultivation, which include the use of A. tumefaciens AGL-1 in a 2:1 ratio (bacteria:fungi) during 72 h at 26°C. Our data show that a single-copy transgene is transferred to S. brasiliensis that is mitotically stable in 99% of cells after 10 generations without selective pressure. In addition, we created a plasmid toolkit that allows the establishment of fusion proteins of any S. brasiliensis gene of interest with sGFP or mCherry under the control of the GAPDH or H2A endogenous promoters. These modules allow different levels of expression of the desired fusion. Moreover, we successfully targeted these fluorescent proteins to the nucleus and used fluorescence-tagged strains to assess phagocytosis. Overall, our data show that the ATMT system is an easy-to-use and efficient genetic toolbox for studies on recombinant expression and gene function in S. brasiliensis. IMPORTANCE Sporotrichosis is the most prevalent subcutaneous mycosis worldwide and has recently become a public health concern. Although immunocompetent hosts are also prone to sporotrichosis, immunodeficient hosts often develop a more severe and disseminated form of disease. To date, the Rio de Janeiro state in Brazil is the most significant feline zoonotic transmission epicenter in the world, with more than 4,000 human and feline diagnosed cases. Cats play an essential role in the S. brasiliensis infection due to their high susceptibility and transmissibility to other felines and humans. S. brasiliensis is the most virulent etiological agent of sporotrichosis, causing the most severe clinical manifestations. Despite the increasing incidence of sporotrichosis, the identification of virulence traits important for disease establishment, development, and severity has been lacking. In this work, we established an efficient genetic toolbox to manipulate S. brasiliensis that will guide future studies to define new virulence mechanisms and a better understanding of host-pathogen interactions from a molecular perspective.

Diet supplementation with egg yolk powder fattens the beetle Tribolium castaneum.

Insects have become essential models in studying human metabolic diseases, mainly due to their low maintenance cost and available tools. Both mutations and modified diets induce metabolic states similar to human obesity and diabetes. Here, we explore the effect of a high-calorie, high-fat diet on the metabolism of the beetle Tribolium castaneum. Supplementation of the wheat flour diet with powdered egg yolk for 3 weeks increased the total triacylglycerol and accelerated larval development. In addition, this diet increased the triacylglycerol levels of adult beetles. However, this egg yolk supplementation did not alter the larvae's total glucose levels or lipogenic capacity and ATP citrate lyase activity. The diet also did not change the expression profile of several lipid and carbohydrate metabolism genes and insulin-like peptides. Thus, we conclude that the diet supplemented with egg yolk induces increased fat without causing diabetes phenotypes, as seen in other hypercaloric diets in insects.

Factors Associated with the Development of Early Complications after Total Knee Arthroplasty.

Objective To diagnose risk factors for the development of local or medical postoperative complications up to 30 days after surgery in patients undergoing total knee arthroplasty Methods The present analysis included all patients who underwent knee arthroplasty performed in this hospital during the study period, based on data from medical records of the patients, with the aim of investigating factors related to the occurrence of local or medical complications during hospitalization and up to 30 days after the procedure, if they needed any additional intervention. Results Out of the 157 patients included in the study, 17.1% had some complication. The most prevalent were arthrofibrosis (6.4%), deep infection (4.4%), and superficial infection (2.5%), among others. Older patients and a greater number of previous comorbidities were associated with a higher risk of postoperative complications. Conclusions Older patients and a greater number of comorbidities were related to an increased risk of postoperative complications. The American Society of Anesthesiologists (ASA) score proved to be insufficient to assess the occurrence of complications after knee arthroplasty and new tools should be used for this purpose.

Factors Associated with the Development of Early Complications after Total Knee Arthroplasty / Fatores associados ao desenvolvimento de complicações precoces após artroplastia total do joelho

Abstract Objective To diagnose risk factors for the development of local or medical postoperative complications up to 30 days after surgery in patients undergoing total knee arthroplasty Methods The present analysis included all patients who underwent knee arthroplasty performed in this hospital during the study period, based on data from medical records of the patients, with the aim of investigating factors related to the occurrence of local or medical complications during hospitalization and up to 30 days after the procedure, if they needed any additional intervention. Results Out of the 157 patients included in the study, 17.1% had some complication. The most prevalent were arthrofibrosis (6.4%), deep infection (4.4%), and superficial infection (2.5%), among others. Older patients and a greater number of previous comorbidities were associated with a higher risk of postoperative complications. Conclusions Older patients and a greater number of comorbidities were related to an increased risk of postoperative complications. The American Society of Anesthesiologists (ASA) score proved to be insufficient to assess the occurrence of complications after knee arthroplasty and new tools should be used for this purpose.

Resumo Objetivo Identificar fatores de risco para o desenvolvimento de complicações pós-operatórias locais ou clínicas ocorridas até 30 dias após a cirurgia em pacientes submetidos a artroplastia total do joelho. Métodos Todos os pacientes submetidos a artroplastia de joelho realizada neste hospital no período do estudo foram incluídos na análise, baseada em dados dos prontuários dos pacientes, para investigar os fatores associados à ocorrência de complicações locais ou clínicas durante o internamento até 30 dias após o procedimento que necessitaram de alguma intervenção. Resultados Dos 157 pacientes incluídos no estudo, 17,1% cursaram com alguma complicação. As mais prevalentes foram artrofibrose (6,4%), infecção profunda (4,4%) e infecção superficial (2,5%), dentre outras. A maior idade e maior número de comorbidades prévias foram relacionadas com maior risco de complicações pós-operatórias. Conclusões A maior idade e maior número de comorbidades foram relacionados a um risco aumentado de complicações pós-operatórias. O escore Sociedade Americana de Anestesiologistas (ASA, na sigla em inglês) se mostrou insuficiente para avaliar a ocorrência de complicações pós artroplastia de joelho e novas ferramentas devem ser empregadas para este fim.

A busca de informação sobre covid-19 na web: uma perspectiva cibermétrica / The search for information about covid-19 on the web: a cybermetric perspective / La búsqueda de información sobre covid-19 en la web: una perspectiva cibermetrica

Demonstrar a influência da pandemia de covid-19 nas buscas realizadas no Google por meio do levantamento de dados em uma aplicação cibermétrica. Método: Estudo de aplicação cibermétrica que utiliza a ferramenta Google Trends e os termos 'covid-19', 'coronavírus', 'cloroquina' e 'vacina contra a covid-19', para o período de 31 de dezembro de 2019 a 17 de janeiro de 2021. Resultados: Reconhecer que as primeiras buscas pelo termo 'covid-19' ocorreram na mesma data do anúncio do primeiro caso confirmado. Ocorreu também o crescimento no volume de busca por informações sobre os sintomas de pneumonia relacionadas com a primeira morte por coronavírus. A intensificação nas consultas relativas a 'covid vaccine allergy' esteve associada ao início da vacinação no mundo. Conclusão: Em períodos de pandemia, a sociedade procura intensamente por informações relacionadas ao seu contexto e a busca pode ser motivada pelos meios de comunicação.

It aims to show the influence of the covid-19 pandemic on the searches on Google, using the data survey in a cybermetric application. Method: It is a cybermetric study that uses the Google Trends tool by searching for 'covid-19', 'cononavírus', 'cloroquina' and 'vacina contra a covid-19' between December 31st, 2019, and January 17th, 2021. Results: It acknowledges that the first searches for the term 'covid-19' were made on the same day of the announcement of the first confirmed case. There was also a rise in the number of searches for information on symptoms of pneumonia related to the first death caused by coronavirus. The intensification in the searches related to 'covid vaccine allergy' was associated to the start of the vaccination in the world. Conclusion: In pandemic times, the society intensely searches for information related to their context and the searches can be motivated by the media.

Demostrar la influencia de la pandemia de la covid-19 en las búsquedas realizadas en Google, mediante la recolección de datos en una aplicación cibermétrica. Método: Estudio de aplicación cibernética utilizando la herramienta Google Trends y los términos 'covid-19', 'coronavírus', 'cloroquina' y 'vacina contra a covid-19' para el período de 31 de diciembre de 2019 al 17 de enero de 2021. Resultados: Reconoce que las primeras búsquedas del término 'covid-19' ocurrieron en la misma fecha que el anuncio del primer caso confirmado. También hubo un aumento en el volumen de búsqueda de información sobre síntomas de neumonía relacionados con la primera muerte por coronavirus. La intensificación de las consultas relacionadas con la 'covid vaccine allergy' se asoció con el inicio de la vacunación en todo el mundo. Conclusión: En períodos de pandemia, la sociedad búsqueda de manera intensiva información relacionada con su contexto y puede ser motivada por los medios de comunicación.

Impact of the COVID-19 Pandemic in the Prevalence of Burnout among Residents in Orthopedics.

Objective The primary objective of the present study is to assess the impact of the COVID-19 pandemic on the prevalence of burnout syndrome among residents in orthopedic surgery. As a secondary objective, characteristics associated with the risk of developing the severe form of the syndrome were assessed. Method In the present cross-sectional study, graduating orthopedic residents were evaluated before and during the COVID-19 pandemic. Medical students formed a control group. The participants answered a sociodemographic questionnaire, the Maslach Burnout Inventory, and the Brazilian validated version of the 36-item short-form health survey questionnaire (SF-36). Fifty-two residents were appraised before the pandemic and 19 during the pandemic. Results Forty-four (84.6%) residents fulfilled the criteria for burnout syndrome, and the severe form of the syndrome was present in 16 (30.7%). There was no significant change in the evaluated scores after the beginning of the COVID-19 pandemic. There was also no increase in the prevalence of burnout syndrome or of the severe form of the syndrome. A negative correlation was observed between SF-36 items and the development of the severe form of burnout syndrome. Conclusion The prevalence of burnout syndrome and of the severe form of the disease was very high among residents in orthopedic surgery. The COVID-19 outbreak does not increase burnout in the residents.

Impact of the COVID-19 Pandemic in the Prevalence of Burnout among Residents in Orthopedics / Impacto da pandemia COVID-19 na prevalência de burnout entre residentes em ortopedia

Abstract Objective The primary objective of the present study is to assess the impact of the COVID-19 pandemic on the prevalence of burnout syndrome among residents in orthopedic surgery. As a secondary objective, characteristics associated with the risk of developing the severe form of the syndrome were assessed. Method In the present cross-sectional study, graduating orthopedic residents were evaluated before and during the COVID-19 pandemic. Medical students formed a control group. The participants answered a sociodemographic questionnaire, the Maslach Burnout Inventory, and the Brazilian validated version of the 36-item short-form health survey questionnaire (SF-36). Fifty-two residents were appraised before the pandemic and 19 during the pandemic. Results Forty-four (84.6%) residents fulfilled the criteria for burnout syndrome, and the severe form of the syndrome was present in 16 (30.7%). There was no significant change in the evaluated scores after the beginning of the COVID-19 pandemic. There was also no increase in the prevalence of burnout syndrome or of the severe form of the syndrome. A negative correlation was observed between SF-36 items and the development of the severe form of burnout syndrome. Conclusion The prevalence of burnout syndrome and of the severe form of the disease was very high among residents in orthopedic surgery. The COVID-19 outbreak does not increase burnout in the residents.

Resumo Objetivo O objetivo principal do presente estudo é avaliar o impacto da pandemia de COVID-19 na prevalência da síndrome de burnout entre residentes de ortopedia Como objetivo secundário, foram avaliadas características associadas ao risco de desenvolver a forma grave da síndrome. MétodoNo presente estudo transversal, foram avaliados residentes antes e durante a pandemia de COVID-19. Estudantes de medicina formaram um grupo de controle. Os participantes responderam a um questionário sociodemográfico, ao Inventário Maslach Burnout, e à versão validada brasileira do Short Form Health Survey 36 (SF-36). Cinquenta e dois residentes foram avaliados antes da pandemia e 19 durante a pandemia. Resultados Quarenta e quatro (84,6%) residentes tinham critérios para síndrome de burnout, e a forma grave da síndrome estava presente em 16 (30,7%). Não houve alteração significativa nos escores avaliados após o início da pandemia de COVID-19. Também não houve aumento na prevalência da síndrome de burnout ou da forma grave da síndrome. Observou-se correlação negativa entre os itens SF-36 e o desenvolvimento da forma grave da síndrome de burnout. Conclusão A prevalência da síndrome de burnout e da forma grave da doença foi muito alta entre os residentes em cirurgia ortopédica. A pandemia de COVID-19 não aumentou o burnout nos residentes.

Analysis of Gabapentin's Efficacy in Tinnitus Treatment: A Systematic Review.

OBJECTIVES: Tinnitus can be a chronic symptom that brings disability and distress. Some studies suggested that gabapentin might be effective on tinnitus relief. The objective of the study is to perform a systematic review in order to evaluate the efficacy of oral gabapentin in patients with tinnitus. METHODS: A literature search was conducted in English and following the recommendations from PRISMA. The terms used were: ("tinnitus" OR "subjective tinnitus") AND ("gabapentin"). The study selection was performed following the eligibility criteria in accordance to the PICOS (population, intervention, comparison, outcome, study design) strategy-patients with tinnitus; oral gabapentin; placebo; reduction of tinnitus severity questionnaires scores; prospective, double-blind, randomized controlled trial, respectively. The selected studies were included in qualitative synthesis. The studies were analyzed according to Joanna Briggs Institute's critical appraisal checklist for randomized controlled trials. RESULTS: One hundred twenty-one studies were found in 9 databases and 8 studies were found in gray literature. After study selection, 6 articles were read in full. Then, 2 studies were excluded and 4 were included in qualitative synthesis. All 4 articles were analyzed according to critical evaluation checklist. CONCLUSIONS: There is insufficient evidence to recommend the use of gabapentin for patients with tinnitus.

Southern coastal subtropical shallow lakes skin temperature driven by climatic and non-climatic factors.

Subtropical coastal shallow lakes (SCSL) are sensitive ecosystems. The lake-skin-water temperature (LSWT) is an average lake temperature proxy and responds to changes in surroundings, affecting biological and physical lake processes. In this study, M*D11A1 products are used to develop daytime and nighttime LSWT time series for 20 SCSL in South America. The influence of climatic (air temperature, surface net solar radiation, wind speed, and wind direction) and non-climatic (latitude, lake area, perimeter, width, length, and morphology) factors are evaluated from 2001 to 2017. Pearson's coefficients (ρ) and auto- and cross-correlations are used to establish the relation between LWST and the selected factors. We identify that the dynamic of LSWT is sensitive to geomorphological factors (latitude and lake width) throughout the year, especially in summer. In winter, the LSTW regime is mainly affected by wind direction (ρ = -0.66, p value < 0.01). Linear models are fitted to the temperature series to check the trend changes in the inflection points and the warming or cooling trend for LSWT. Considering the complete series, the maximum warming rate of LSWT is 0.25 °C per decade (°C/dec). The analysis of the identified sub-periods reveals that warming and cooling can occur (significantly) in shorter periods. The average trends within sub-periods for skin temperature-daytime (± 0.0105 °C/dec), skin temperature-nighttime (0.0041 °C/dec), and air temperature (- s0.006 °C/dec; 0.007 °C/dec) are estimated. Our approach has the potential to be applied in future studies due to the expansion of knowledge about the behavior of SCSL and the understanding of the current and potential effects of climate change in association with physical and geomorphological traits.